Provider Demographics
NPI:1073733911
Name:VANHAAREN, WILHELMUS ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILHELMUS
Middle Name:ALBERT
Last Name:VANHAAREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 ALGONQUIN DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-5535
Mailing Address - Country:US
Mailing Address - Phone:401-463-8406
Mailing Address - Fax:
Practice Address - Street 1:399 ALGONQUIN DR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-5535
Practice Address - Country:US
Practice Address - Phone:401-463-8406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI03745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine