MARK VANDERMYDE

Physician Assistant

Active Individual
NPI: 1568543502

Practice Address

7901 ANGLING RD
Portage, MI 49024

Phone: (269) 324-8405

Specialties

Specialty Code Primary License
Physician Assistant 363A00000X Yes 5601003052 (MI)

Frequently Asked Questions

NPI 1568543502 is the National Provider Identifier for MARK VANDERMYDE, a Physician Assistant provider located in Portage, MI. This NPI was enumerated on October 18, 2006.
MARK VANDERMYDE practices at 7901 ANGLING RD, Portage, MI 49024.

Quick Facts

NPI
1568543502
Type
Individual
Enumerated
Oct 18, 2006
Last Updated
Jul 8, 2007

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