Provider Demographics
NPI:1568401032
Name:VANLOWE-PRINCE, SHEILA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:VANLOWE-PRINCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 PARCHMENT DR SE STE 120
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2377
Mailing Address - Country:US
Mailing Address - Phone:616-949-0000
Mailing Address - Fax:616-949-5943
Practice Address - Street 1:847 PARCHMENT DR SE STE 120
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2377
Practice Address - Country:US
Practice Address - Phone:616-949-0000
Practice Address - Fax:616-949-5943
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301054954208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4842601Medicaid
MI110D148370OtherBC/BS
MID14837007Medicare ID - Type UnspecifiedMEDICARE
MIF70309Medicare UPIN