Provider Demographics
NPI:1053075358
Name:EVERT HEALTH, PLLC
Entity Type:Organization
Organization Name:EVERT HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDER VLIET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-574-7445
Mailing Address - Street 1:909 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-1755
Mailing Address - Country:US
Mailing Address - Phone:248-820-1712
Mailing Address - Fax:248-469-0966
Practice Address - Street 1:1311 HARVARD RD
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1912
Practice Address - Country:US
Practice Address - Phone:248-736-7553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-24
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty