Provider Demographics
NPI:1558985127
Name:VRIEND-DEHART, LUKE SAMUEL
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:SAMUEL
Last Name:VRIEND-DEHART
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:LUKE
Other - Middle Name:SAMUEL
Other - Last Name:VRIEND-DEHART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:602 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4918
Mailing Address - Country:US
Mailing Address - Phone:616-392-5141
Mailing Address - Fax:616-391-3755
Practice Address - Street 1:602 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423
Practice Address - Country:US
Practice Address - Phone:616-392-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-30
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351049555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine