DYLAN JACOB VONDERHUEVEL MD
NPI 1902600729
Student in an Organized Health Care Education/Training Program in Southfield, MI

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 02, 2025PECOS Enrolled

22250 PROVIDENCE DR STE 301, SOUTHFIELD, MI 48075(248) 849-3281(248) 849-5449 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dylan Jacob Vonderhuevel Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DYLAN JACOB VONDERHUEVEL MD (NPI 1902600729) is an individual student in an organized health care education/training program in Southfield, Michigan, licensed in Michigan (4351054170) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902600729

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDYLAN JACOB VONDERHUEVELCredential: MD

Location Address22250 PROVIDENCE DR STE 301Southfield, MI 48075-6211

Mailing Address22250 Providence Dr Ste 301Southfield, MI 48075-6211 · (248) 849-3281 · Fax (248) 849-5449

Phone(248) 849-3281

Fax(248) 849-5449

Sole ProprietorNo

Enumeration DateApril 2, 2025

Last NPPES UpdateApril 17, 2025

NPPES CertifiedApril 17, 2025

✔ NPI 1902600729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in MI · 4351054170

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

22250 PROVIDENCE DR STE 301, Southfield, MI 48075

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dylan Jacob Vonderhuevel Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.