Healthcare Provider Details

I. General information

NPI: 1831187608
Provider Name (Legal Business Name): WILLIAM JOHN VANDENBELT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3175 W PROFESSIONAL DR
BAY CITY MI
48706
US

IV. Provider business mailing address

501 LAPEER AVE
SAGINAW MI
48607-1208
US

V. Phone/Fax

Practice location:
  • Phone: 989-667-3377
  • Fax: 989-667-9991
Mailing address:
  • Phone: 989-759-6464
  • Fax: 989-399-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301029467
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: