Mark Leroy Vanderweide, CRNA | |
14700 Lake Shore Dr, Charlevoix, MI 49720-1999 | |
(231) 547-4024 | |
Not Available |
Full Name | Mark Leroy Vanderweide |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 14700 Lake Shore Dr, Charlevoix, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1225758824 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 4704293836 (Michigan) | Primary |
Entity Name | Munson Healthcare Charlevoix Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326124058 PECOS PAC ID: 4284528035 Enrollment ID: O20040211001170 |
Mailing Address | Practice Location Address |
---|---|
Mark Leroy Vanderweide, CRNA 854 Dorroll St Ne, Grand Rapids, MI 49505-4209 Ph: (616) 914-6532 | Mark Leroy Vanderweide, CRNA 14700 Lake Shore Dr, Charlevoix, MI 49720-1999 Ph: (231) 547-4024 |
Michael C Macmillan, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 12375 Indian Place Dr, Charlevoix, MI 49720 Phone: 231-547-2496 Fax: 231-547-2823 | |
Michael Johnson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Jennifer L Simons, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 | |
Mel Choponis, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Kenneth Forrester, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Madeline Jeakle Nemes, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 |