Provider Demographics
NPI:1346234036
Name:VANDYKE, ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:VANDYKE
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 1:7200 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-7522
Mailing Address - Country:US
Mailing Address - Phone:440-942-5400
Mailing Address - Fax:440-942-9055
Practice Address - Street 1:7200 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-7522
Practice Address - Country:US
Practice Address - Phone:440-942-5400
Practice Address - Fax:440-942-9055
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35041502207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0436826Medicaid
OH0436826Medicaid