John R Vydareny Md Pc in Grand Rapids - Dermatology
John R Vydareny Md Pc - NPI 1255502605
John R Vydareny Md Pc is a Dermatology in Grand Rapids, Michigan. John R Vydareny Md Pc practices all healthcare services and medical treatments related to Dermatology. The NPI Number for John R Vydareny Md Pc is 1255502605. The last update date is 2008-04-17.
John R Vydareny Md Pc's current location address is 1900 Wealthy St Se, Grand Rapids, Michigan. You can contact this provider via phone number 6164591144 and fax number 6164593594. The mailing address for John R Vydareny Md Pc is 1900 Wealthy St Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | John R Vydareny Md Pc |
|---|---|
| Address | 1900 Wealthy St Se, Grand Rapids, Michigan |
| Phone Number | 6164591144 |
| Fax Number | 6164593594 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Vydareny R John |
| Credentials | MD |
| Telephone Number | 6164591144 |
NPI Number Detail
| NPI Number | 1255502605 |
|---|---|
| Provider Enumeration Date | 2008-03-13 |
| Last Updated Date | 2008-04-17 |
Provider Mailing Address Detail
| Address | 1900 Wealthy St Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495062969 |
| Phone Number | 6164591144 |
| Fax Number | 6164593594 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | JV028722 |
|
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 | -- |
Post Comment/ Review Below
What is the John R Vydareny Md Pc's unique identification number?
The John R Vydareny Md Pc has been assigned the NPI (National Provider Identifier) Number 1255502605 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete physical location address of John R Vydareny Md Pc?
The John R Vydareny Md Pc is physically situated at 1900 Wealthy St Se, in the city of Grand Rapids, state of MI, with the postal code 495062969.
What is John R Vydareny Md Pc's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for John R Vydareny Md Pc is Dermatology, and the taxonomy classification code that categorizes this area of expertise is 207N00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1255502605 to John R Vydareny Md Pc?
The John R Vydareny Md Pc received its 1255502605 assignment from the Centers for Medicare & Medicaid Services on 2008-03-13.
When was the information pertaining to John R Vydareny Md Pc most recently updated or revised?
The details related to John R Vydareny Md Pc, including its address, specialty, and other relevant information, were last updated or revised on 2008-04-17.
NPI Number: 1902802911
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