DR. ANDREA EMMA VAN PELT


Address: 4070 Lake Drive Se, Suite 202, Grand Rapids, MI 49546
Phone: 6164644420

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0122X Surgery
Specialization: Plastic and Reconstructive Surgery
4301095522 MI Allopathic & Osteopathic Physicians

Office Location

Street Address 4070 LAKE DRIVE SE
SUITE 202
City GRAND RAPIDS
State MI
Zip Code 49546

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 2086S0122X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Plastic and Reconstructive Surgery

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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

Competitor

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City GRAND RAPIDS
Zip Code 49546

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Dataset Information

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.

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