Provider Demographics
NPI:1851647218
Name:VELDKAMP, ABIGAIL FAITH (OD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:FAITH
Last Name:VELDKAMP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 RANCH DR NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-2518
Mailing Address - Country:US
Mailing Address - Phone:616-826-1533
Mailing Address - Fax:
Practice Address - Street 1:4284 PLAINFIELD AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1612
Practice Address - Country:US
Practice Address - Phone:616-364-6228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004726152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist