Vidic, Thomas R.

Vidic, Thomas R. is an individual health care provider with primary practice located at 303 S Nappanee St , Elkhart IN 46514-2066. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Vidic, Thomas R. can be contacted via phone (574) 296-3282.

Contact Information

Primary practice address
303 S Nappanee St Elkhart IN 46514-2066
Phone: (574) 296-3282
Fax: (574) 296-3324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 01033614A Indiana

Profile Details

NPI number 1265437404
LBN Legal business name Vidic, Thomas R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Dec 19th, 2012 - about 13 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 1265437404 NPPES
Indiana MEDICAID 100112810A

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