John R. Vydareny in Grand Rapids - Dermatology
John R. Vydareny - NPI 1619958576
John R. Vydareny is a Dermatology in Grand Rapids, Michigan. John R. Vydareny practices all healthcare services and medical treatments related to Dermatology. The NPI Number for John R. Vydareny is 1619958576. The last update date is 2015-03-16.
John R. Vydareny's current location address is 833 Michigan St Ne, Grand Rapids, Michigan. You can contact this provider via phone number 6164591144 and fax number 6164590313. The mailing address for John R. Vydareny is 833 Michigan St Ne, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John R. Vydareny |
|---|---|
| Address | 833 Michigan St Ne, Grand Rapids, Michigan |
| Phone Number | 6164591144 |
| Fax Number | 6164590313 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1619958576 |
|---|---|
| Provider Enumeration Date | 2005-11-08 |
| Last Updated Date | 2015-03-16 |
Provider Mailing Address Detail
| Address | 833 Michigan St Ne |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495033523 |
| Phone Number | 6164591144 |
| Fax Number | 6164590313 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | JV028722 |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1075285 | MI | -- |
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What is the John R. Vydareny's unique identification number?
The John R. Vydareny has been assigned the NPI (National Provider Identifier) Number 1619958576 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the John R. Vydareny located?
The John R. Vydareny is located at 833 Michigan St Ne, Grand Rapids, MI 495033523.
What is John R. Vydareny's specialized field of practice, and what is the corresponding taxonomy classification code?
The John R. Vydareny's area of specialization is Dermatology, and the corresponding taxonomy code that categorizes this field of practice is 207N00000X.
On what date did the John R. Vydareny receive its 1619958576 assignment from the Centers for Medicare & Medicaid Services?
The John R. Vydareny was assigned its 1619958576 by the Centers for Medicare & Medicaid Services on 2005-11-08.
As of what date were the John R. Vydareny's details last updated?
The information pertaining to the John R. Vydareny, including its address, specialty, and other details, was most recently updated on 2015-03-16.