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Contact Information

PETER S. VANDEMARK, MD, PC
705 OAK STREET
SUITE 11
BIG RAPIDS, MI49307
 Phone: 231-796-4406
 Fax: 231-796-2770
 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, MD, PC

NPI # 1376643155
LBN Legal business name PETER S. VANDEMARK, MD, PC
Authorized official PETER VANDEMARK - (PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/22/2006
Last updated 07/25/2007 - About 19 years ago
Identifiers
MI License # 4301038966
MI Medicaid 3377875
MI Other 0540004 BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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