NPI 1255502605

John R Vydareny MD PC

Organisation Dermatology Physician Grand Rapids, MI

Practice location

Address: 1900 Wealthy St SE, Grand Rapids, MI 49506-2969
Phone: (616) 459-1144
Fax: (616) 459-3594

Authorised official

Name: John R Vydareny
Title: Owner
Phone: (616) 459-1144

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence JV028722 (MI)

Other Dermatology providers in Michigan →

Registry record

NPI: 1255502605
Entity type: Organization
NPI issued: 13 Mar 2008
Record last updated: 17 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.