Robert R. Vanderzwaag Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01048973A Issued in IN

Practice address

5314 Lincolnway East
Mishawaka, IN 46544-4249

Phone

(574) 256-9032

Fax

(574) 256-9049

NPI assigned

Jul 20, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1811996846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1887",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465151887",
            "telephone_number": "574-389-0542",
            "fax_number": "574-522-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5314 LINCOLNWAY EAST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444249",
            "telephone_number": "574-256-9032",
            "fax_number": "574-256-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERZWAAG",
        "first_name": "ROBERT",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01048973A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - OSCEOLA",
            "identifier": "000000692030",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200147150A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS #",
            "identifier": "000000109343",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Lynn Vanbuskirk, PHARM. D.
• Iris Vance, PT
• Travis Wayne Vander Reyden, P.T.
• Katrina T Vanderveen, MD
• Robert Vanderwal, MS, LMHC
• Jerrold A Vandyke, MD
• Kathryn Susan Vansickle, M.S.CCC-SLP
• Thomas P Varied, M.D.
• Jennifer S. Vascil, MS, CCC-SLP
• Mikaela Vellucci

• Family Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.