Mcdaniel-Vanderzwaag, Bethany L.

Mcdaniel-Vanderzwaag, Bethany L. is an individual health care provider with primary practice located at 3421 Cassopolis Street Ste 200 , Elkhart IN 46514-6774. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mcdaniel-Vanderzwaag, Bethany L. can be contacted via phone (574) 335-8180.

Contact Information

Primary practice address
3421 Cassopolis Street Ste 200 Elkhart IN 46514-6774
Phone: (574) 335-8180
Fax: (574) 335-0842
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01048946A Indiana

Profile Details

NPI number 1639178650
LBN Legal business name Mcdaniel-Vanderzwaag, Bethany L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Mar 27th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639178650 NPPES
Indiana MEDICAID 200147110
Indiana Other 1100030865

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