Ermolin, Vitaly E
Ermolin, Vitaly E is an individual health care provider with primary practice located at 55 Fogg Rd , Weymouth MA 02190-2432. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ermolin, Vitaly E can be contacted via phone (781) 624-8000.Contact Information
Primary practice address
55 Fogg Rd
Weymouth MA 02190-2432
Phone: (781) 624-8000
Fax: (781) 878-6750
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 246085 | Massachusetts |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME 88741 | Florida |
Profile Details
| NPI number | 1114901485 |
|---|---|
| LBN Legal business name | Ermolin, Vitaly E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2005 |
| Last updated | Nov 4th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114901485 | NPPES |
| Florida | MEDICAID | 268992800 |
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