Provider Demographics
NPI:1770685950
Name:VAID, VIVEK C (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVEK
Middle Name:C
Last Name:VAID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10509 ALLOWAY DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1662
Mailing Address - Country:US
Mailing Address - Phone:301-299-8924
Mailing Address - Fax:
Practice Address - Street 1:3311 TOLEDO TER STE B102
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-8146
Practice Address - Country:US
Practice Address - Phone:301-559-3500
Practice Address - Fax:301-853-2362
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD-17843207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC62619Medicare UPIN
DC00B109V38Medicare PIN