Provider Demographics
NPI:1831187608
Name:VANDENBELT, WILLIAM JOHN (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOHN
Last Name:VANDENBELT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:501 LAPEER AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6464
Mailing Address - Fax:989-399-8233
Practice Address - Street 1:3175 W PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706
Practice Address - Country:US
Practice Address - Phone:989-667-3377
Practice Address - Fax:989-667-9991
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301029467207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P75164OtherBLUE CARE NETWORK OF MICH
193892OtherCIGNA
381908328OtherTRICARE
MI1831187608Medicaid
4532190OtherMOLINA HEALTH CARE OF MI
0998824OtherHEALTHPLUS OF MICHIGAN
108779OtherGREAT LAKES HEALTH PLAN
110OtherCOMMUNITY CHOICE OF MI
4005484OtherAETNA
700G361110OtherBCBS OF MICHIGAN
700G361110OtherBCBS OF MICHIGAN
4532190OtherMOLINA HEALTH CARE OF MI