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Contact Information

PETER S VANDEMARK, MD
1019 CAMPUS DRIVE
BIG RAPIDS, MI49307
 Phone: 231-591-5961
 Fax: 231-591-5970
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PETER S VANDEMARK · (Male)

NPI # 1437130606
Status Active
Credentials MD
Entity Individual
Enumeration date 11/07/2005
Last updated 01/19/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301038966
  • MI Medicaid 3377875
  • MI Other 0540004 BLUE CROSS BLUE SHIELD
  • MI Other 110154022 PALMETTO GBA RAILROAD MR
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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