Vining, Mark Alan

Vining, Mark Alan is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Pediatrics, Worcester MA 01655-0002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Vining, Mark Alan can be contacted via phone (508) 334-2853.

Contact Information

Primary practice address
55 Lake Ave N Department Of Pediatrics Worcester MA 01655-0002
Fax: (508) 856-1042
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 205146 Massachusetts

Profile Details

NPI number 1407838642
LBN Legal business name Vining, Mark Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Sep 20th, 2023 - about 2 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 1407838642 NPPES
Massachusetts MEDICAID 0129780

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