Vandyke, Stephen J

Vandyke, Stephen J is an individual health care provider with primary practice located at 1611 Anne St Nw , Bemidji MN 56601-5114. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Vandyke, Stephen J can be contacted via phone (218) 333-2020.

Contact Information

Primary practice address
1611 Anne St Nw Bemidji MN 56601-5114
Phone: (218) 333-2020
Fax: (218) 333-2019
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 1839 Minnesota
Eye and Vision Services Providers / Optometrist 152W00000X 1839 Minnesota

Profile Details

NPI number 1003923012
LBN Legal business name Vandyke, Stephen J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Dec 16th, 2011 - about 14 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 1003923012 NPPES
Other 10723 ND BCBS
MEDICAID 016323600 ND BCBS
Other 934731 ND BCBS
Other HP17316 ND BCBS
Other 2219746 ND BCBS
Other 49B66VA ND BCBS
Other 912049 ND BCBS

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