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:
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Health care specialties

SpecialtyCodeLicense #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 11 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 1619958576 NPPES
Michigan MEDICAID 1075285

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