John R Vydareny Md Pc

LBN: John R Vydareny Md Pc
John R Vydareny Md Pc is an health care organization with primary practice located at 1900 Wealthy St Se , Grand Rapids MI 49506-2969. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. John R Vydareny Md Pc can be contacted via phone (616) 459-1144, or through Vydareny, John R via phone (616) 459-1144.

Contact Information

Primary practice address
1900 Wealthy St Se Grand Rapids MI 49506-2969
Phone: (616) 459-1144
Fax: (616) 459-3594
Website:
Map and Directions
Authorized official contact:
Name: Vydareny, John R Doctor of Medicine (MD)
Phone: (616) 459-1144

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X JV028722 Michigan

Profile Details

NPI number 1255502605
LBN Legal business name John R Vydareny Md Pc
DBA Doing business as
Authorized official Vydareny, John R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 13th, 2008
Last updated Apr 17th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255502605 NPPES
Michigan MEDICAID 1075285

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