DR. ANDREA EMMA VAN PELT (NPI# 1285756148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285756148 |
Entity Type | Individual |
Full Name | DR. ANDREA EMMA VAN PELT |
Credential | M.D. |
Practice Address |
4070 Lake Drive Se Suite 202 Grand Rapids MI 49546 |
Mailing Address |
4070 Lake Drive Se Suite 202 Center for Breast & Body Contouring Grand Rapids MI 49546 |
Practice Telephone | 6164644420 |
Practice Fax Number | 6164644354 |
Mailing Telephone | 6164644420 |
Mailing Fax Number | 6464644354 |
Enumeration Date | 2007-04-04 |
Last Update Date | 2013-03-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
4301095522 | MI | Allopathic & Osteopathic Physicians |
Street Address |
4070 LAKE DRIVE SE SUITE 202 |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49546 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043859614 | Audrey Mitchell, LLC | Clinic/Center | 4070 Lake Drive Se, Suite 101, Grand Rapids, MI 49546-4954 | 2019-12-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
Find all providers in zip 49546 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689761439 | John J Iacobucci | Surgery | 221 Michigan St Ne Ste 300, Grand Rapids, MI 49503-2537 | 2006-10-05 |
1710996319 | Ewa D Komorowska-timek | Surgery | 3855 Burton St Se Ste A, Grand Rapids, MI 49546-5816 | 2006-08-05 |
1891739363 | Benjamin P Rechner Md PC | Surgery | 985 Parchment Dr Se, Grand Rapids, MI 49546-3659 | 2006-06-15 |
1710977723 | Mithilesh J Mishra | Surgery | 1400 Michigan St Ne, Grand Rapids, MI 49503-2032 | 2005-10-21 |
1710369756 | Joshua Paul Kelley | Surgery | 221 Michigan St Ne, Ste 300, Grand Rapids, MI 49503-2543 | 2015-06-26 |
1902057805 | Joseph F. Looby, D.o., P.C. | Surgery | 2540 Woodmeadow Dr Se, Suite 102, Grand Rapids, MI 49546-8050 | 2008-10-09 |
1245394576 | Hand & Plastic Surgery Centre Plc | Surgery | 245 Cherry St Se, Suite 302, Grand Rapids, MI 49503-4607 | 2006-12-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629528765 | Paragon Health, P.C. | Surgery | 8175 Creekside Dr Ste 100, Portage, MI 49024-5370 | 2016-10-13 |
1487091989 | Trevor K O'brien | Surgery | 4110 Copper Ridge Dr Ste 242, Traverse City, MI 49684-6721 | 2013-05-24 |
1851689525 | Robert Moore Oneal | Surgery | 501 Onondaga St, Ann Arbor, MI 48104-2606 | 2011-07-15 |
1902072952 | Michigan Cosmetic & Reconstructive Surgery Pllc | Surgery | 29110 Inkster Rd, Ste 250, Southfield, MI 48034-1098 | 2008-04-30 |
1518184175 | Halil Ibrahim Canter | Surgery | 16001 West 9 Mile Rd., 3 Fl Fischer Ctr Providence Hosp. Craniofacial Inst., Southfield, MI 48075 | 2007-04-18 |
1083741367 | Kenneth Wolf | Surgery | 1990 Union Lake Rd Ste 200, Commerce Township, MI 48382-2200 | 2007-02-27 |
1972630259 | Lauran Bryan | Surgery | 26711 Woodward Ave Ste Ll1, Huntington Woods, MI 48070-1370 | 2007-02-27 |
1689689259 | Milena Diana Lambie | Surgery | 27750 Middlebelt Rd Ste 150, Farmington Hills, MI 48334-5007 | 2006-07-30 |
1164484796 | Pramit S Malhotra | Surgery | 900 E Michigan Ave, Ste 108, Jackson, MI 49201-2457 | 2006-04-06 |
1588657712 | Melek Ronald Kayser | Surgery | 29167 Jefferson Ave, Saint Clair Shores, MI 48081-1331 | 2005-08-23 |
Find all providers with the same taxonomy |
City | GRAND RAPIDS |
Zip Code | 49546 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.