Provider Demographics
NPI:1720248610
Name:VANMIEGHEM, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:VANMIEGHEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2980 SQUALICUM PKWY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1880
Mailing Address - Country:US
Mailing Address - Phone:360-647-3377
Mailing Address - Fax:360-752-3214
Practice Address - Street 1:2980 SQUALICUM PKWY
Practice Address - Street 2:SUITE 304
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1880
Practice Address - Country:US
Practice Address - Phone:360-647-3377
Practice Address - Fax:360-752-3214
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60273897207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA293893OtherL&I