Healthcare Provider Details

I. General information

NPI: 1912174921
Provider Name (Legal Business Name): ARTHUR R VENDOLA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E MICHIGAN AVE SUITE 202
JACKSON MI
49201-1847
US

IV. Provider business mailing address

1100 E MICHIGAN AVE SUITE 202
JACKSON MI
49201
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-6210
  • Fax:
Mailing address:
  • Phone: 517-787-6210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTHUR R VENDOLA
Title or Position: OWNER
Credential: MD
Phone: 517-787-6210