Provider Demographics
NPI:1609982727
Name:VANZEE, AARON (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:VANZEE
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 1:5150 CASCADE RD SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3794
Mailing Address - Country:US
Mailing Address - Phone:616-940-3168
Mailing Address - Fax:616-940-3352
Practice Address - Street 1:5150 CASCADE RD SE
Practice Address - Street 2:SUITE B
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3794
Practice Address - Country:US
Practice Address - Phone:616-940-3168
Practice Address - Fax:616-940-3352
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301D72352208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI350D16208OtherBCBS MICHIGAN
MI4301906Medicaid