Individual ProviderWilliam Christian VandenbergPhysical Medicine & RehabilitationAllopathic & Osteopathic PhysiciansPractice Address235 Wealthy St SE, Suite 100, Grand Rapids, MI 49503-5229(616) 840-8186PECOS EnrollmentBased on the most recent information from CMS, provider William Christian Vandenberg does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:10 AM.Profile DetailsProvider ID1700829686Provider TypeIndividualFull NameVandenberg, William ChristianTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date6/14/2006Last Updated5/19/2015Contact InformationPractice LocationPractice Address235 Wealthy St SE, Suite 100, Grand Rapids, MI 49503-5229Phone(616) 840-8186Fax(616) 840-9637Mailing LocationMailing Address235 Wealthy St SE, Suite 100, Grand Rapids, MI 49503-5229Phone(616) 840-8186Fax(616) 840-9637Provider TaxonomiesCodeDescriptionLicenseCode208100000XPrimaryDescriptionPhysical Medicine & RehabilitationAllopathic & Osteopathic PhysiciansLicense4301054341MichiganProvider IdentifiersIDDescriptionIssuerIDWV054341DescriptionOtherIssuerSTATE LICENSEMichiganID2577414DescriptionMedicaidIssuerUnlistedMichigan