Van Ittersum, Jason Barrett

Van Ittersum, Jason Barrett is an individual health care provider with primary practice located at 6225 Prairie St , Norton Shores MI 49444-7831. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Van Ittersum, Jason Barrett can be contacted via phone (231) 798-9500.

Contact Information

Primary practice address
6225 Prairie St Norton Shores MI 49444-7831
Phone: (231) 798-9500
Fax: (231) 798-9533
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X JV074360 Michigan
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 4301074360 Michigan

Profile Details

NPI number 1750303079
LBN Legal business name Van Ittersum, Jason Barrett
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Mar 28th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1750303079 NPPES
Michigan MEDICAID 4532162

Popular Providers