Vial, Ivan Nicolas

Vial, Ivan Nicolas is an individual health care provider with primary practice located at 2450 Ne Mary Rose Pl Ste 201 , Bend OR 97701-7133. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Vial, Ivan Nicolas can be contacted via phone (541) 317-0808.

Contact Information

Primary practice address
2450 Ne Mary Rose Pl Ste 201 Bend OR 97701-7133
Phone: (541) 317-0808
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X MD180009 Oregon

Profile Details

NPI number 1811284433
LBN Legal business name Vial, Ivan Nicolas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2011
Last updated Jun 11th, 2019 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811284433 NPPES
Oregon MEDICAID 500719243

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