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:
Health care specialties
| Specialty | Code | License # | 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 7 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 | 1811284433 | NPPES |
| Oregon | MEDICAID | 500719243 |
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