Provider Demographics
NPI:1346347598
Name:YUAN, VINCENT C (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:C
Last Name:YUAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5855
Mailing Address - Country:US
Mailing Address - Phone:508-820-8332
Mailing Address - Fax:508-370-0229
Practice Address - Street 1:571 UNION AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5855
Practice Address - Country:US
Practice Address - Phone:508-820-8332
Practice Address - Fax:508-370-0229
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3077519Medicaid
MAE82517Medicare UPIN
YUJ10972Medicare ID - Type Unspecified