Vydrin, Mikhail
Vydrin, Mikhail is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Neurology, Worcester MA 01655-0002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Vydrin, Mikhail can be contacted via phone (508) 334-2527.Contact Information
Primary practice address
55 Lake Ave N Department Of Neurology
Worcester MA 01655-0002
Phone: (508) 334-2527
Fax: (508) 334-6778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sleep Medicine | 2084S0012X | 153858 | Massachusetts |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 153858 | Massachusetts |
Profile Details
| NPI number | 1972588077 |
|---|---|
| LBN Legal business name | Vydrin, Mikhail |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 12th, 2005 |
| Last updated | Dec 15th, 2020 - about 4 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 | 1972588077 | NPPES |
| Massachusetts | MEDICAID | 3171965 |
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