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General NPI Number Information
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NPI Number | 1922536986
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Entity Type | Organization
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Legal Business Name | V DERMATOLOGY
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1225 W FRONT ST STE C
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2368
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Country | US
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Telephone | 231-642-5031
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Fax | 231-525-2306
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Provider Business Mailing Address
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Address Line | 1225 W FRONT ST STE C
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2368
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Country | US
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Telephone | 231-642-5031
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Fax | 231-525-2306
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Authorized Official
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Title or Position | DOCTOR
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Name | ANTHONY VANVREEDE
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Credential |
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Telephone | 231-735-1167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | MI
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