Vydareny, John R.
Vydareny, John R. is an individual health care provider with primary practice located at 833 Michigan St Ne Suite 102, Grand Rapids MI 49503-3523. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Vydareny, John R. can be contacted via phone (616) 459-1144.Contact Information
Primary practice address
833 Michigan St Ne Suite 102
Grand Rapids MI 49503-3523
Phone: (616) 459-1144
Fax: (616) 459-0313
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | JV028722 | Michigan |
Profile Details
NPI number | 1619958576 |
---|---|
LBN Legal business name | Vydareny, John R. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 8th, 2005 |
Last updated | Mar 16th, 2015 - about 10 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 | 1619958576 | NPPES |
Michigan | MEDICAID | 1075285 |
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