Provider Demographics
NPI:1588808737
Name:LUDWIG, VINCENT MICHAEL (P-AC)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:MICHAEL
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:P-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-5019
Mailing Address - Country:US
Mailing Address - Phone:508-650-7432
Mailing Address - Fax:508-650-7883
Practice Address - Street 1:67 UNION STREET
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760
Practice Address - Country:US
Practice Address - Phone:508-650-7432
Practice Address - Fax:508-650-7883
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA3706363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant