Provider Demographics
NPI:1437727344
Name:VANDERMEY, JOEL DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:DAVID
Last Name:VANDERMEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5961 TOSCANA DR APT 1014
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3497
Mailing Address - Country:US
Mailing Address - Phone:321-279-3539
Mailing Address - Fax:
Practice Address - Street 1:75B LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4353
Practice Address - Country:US
Practice Address - Phone:828-258-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program