Healthcare Provider Details

I. General information

NPI: 1568666808
Provider Name (Legal Business Name): DIRK HENDRIK VANMEURS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 MARYSVILLE BLVD
SACRAMENTO CA
95838-4512
US

IV. Provider business mailing address

3441 MARYSVILLE BLVD
SACRAMENTO CA
95838-4512
US

V. Phone/Fax

Practice location:
  • Phone: 916-563-7200
  • Fax: 916-563-7220
Mailing address:
  • Phone: 916-563-7230
  • Fax: 916-563-7229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG40574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: