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1154373249

NPI Code Detail

MEDICARE: KEVIN L VANALLEN MD

MEDICARE: KEVIN L VANALLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	4301053221	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1598712390	OTHER	MI	GROUP NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0804103371	OTHER	MI	BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154373249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN L VANALLEN MD

Provider Business Mailing Address
First Line	:	100 MICHIGAN ST NE # MC845
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-2560
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15100 WHITTAKER WAY
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-8696
Country	:	US
Telephone Number	:	616-935-6200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/16/2021

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Directions to “ KEVIN L VANALLEN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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