Most Relevant Information
Provider Data
| NPI Number: | 1003516048 |
| Provider Name: | MEGAN RACHELLE VANDERKAMP |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 5601009229 |
Most Important Dates
| Enumeration Date: | 03/08/2023 |
| Last Updated: | 03/08/2023 |
Provider Practice Location
119 PROSPECT AVE NE
GRAND RAPIDS
MI
495033379
Practice Location Phone/Fax
| Phone: | 6168263174 |
| Fax: |
Provider Mailing Location
119 PROSPECT AVE NE
GRAND RAPIDS
MI
495033379
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |