Marc Vander Vliet, M.D.

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

4301500291 Issued in MI

Practice address

26677 W 12 Mile Rd Ste 166
Southfield, MI 48034-1514

Phone

(313) 306-2023

NPI assigned

Apr 9, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mvandervilet515971@direct.hfhs.org
• Direct secure messaging: mvandervliet@landmarkhealth-direct.org
• Direct secure messaging: mvliet@landmarkhealth-direct.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1790171304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "CLARA FORD PAVILION--4TH FLOOR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-4098",
            "fax_number": "313-916-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26677 W 12 MILE RD STE 166",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341514",
            "telephone_number": "313-306-2023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W. Grand Blvd",
            "address_2": "Clara Ford Pavilion--4th Floor",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48202",
            "country_code": "US",
            "telephone_number": "313-916-4098",
            "fax_number": "313-916-1925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDER VLIET",
        "first_name": "MARC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MI",
            "license": "4301500291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Huang Van Laere, M.D.
• Jonathan Victor Van Lare, PHARM. D.
• Shelby Vanas
• Cheryl Lynne Vanbeck, RDH
• Dylan Philip Vandell
• John G Vanderford, D.O.
• Brittany Vanderhoef
• Imaobong Ibokette Vanderpool, NP
• Vaneni Medical Supplies LLC
• Xiong Vang, CNMT

• Hospice and Palliative Medicine (Internal Medicine) Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.