Healthcare Provider Details

I. General information

NPI: 1326567264
Provider Name (Legal Business Name): THOMAS ONDERLINDE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 ROBERT JONES WAY
KALAMAZOO MI
49009-1904
US

IV. Provider business mailing address

2520 ROBERT JONES WAY
KALAMAZOO MI
49009-1904
US

V. Phone/Fax

Practice location:
  • Phone: 269-375-0400
  • Fax: 269-492-0660
Mailing address:
  • Phone: 269-375-0400
  • Fax: 269-492-0660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601008374
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: