Individual provider · Type 1 NPI

Kevin Vandokkumburg, PA-C

Surgical Physician Assistant · Grand Rapids, MI

NPI number 1134514490 Active

Practice location

2144 E Paris Ave SE Ste 240
Grand Rapids, MI 49546-6117

Fax (616) 949-1115

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X5601007350 (MI)
Surgical Physician Assistant Primary 363AS0400X5601007350 (MI)

Surgical Physician Assistant: Definition to come...

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About NPI 1134514490

Kevin Vandokkumburg, PA-C's National Provider Identifier is 1134514490, issued on Apr 3, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Grand Rapids, MI. The record was last updated on Jun 12, 2023.