Provider Demographics
NPI:1780816678
Name:VEDBRAT S. VAID, M.D.,,P.S.
Entity Type:Organization
Organization Name:VEDBRAT S. VAID, M.D.,,P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VEDBRAT
Authorized Official - Middle Name:SHIVANETH
Authorized Official - Last Name:VAID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-838-2551
Mailing Address - Street 1:508 W 6TH AVE
Mailing Address - Street 2:STE. 410
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2770
Mailing Address - Country:US
Mailing Address - Phone:509-838-2551
Mailing Address - Fax:509-838-2552
Practice Address - Street 1:508 W 6TH AVE
Practice Address - Street 2:STE. 410
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2770
Practice Address - Country:US
Practice Address - Phone:509-838-2551
Practice Address - Fax:509-838-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00010943174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA12773OtherDEPARTMENT OF LABOR AND INDUSTRIES
WA1899301Medicaid
WA12773OtherDEPARTMENT OF LABOR AND INDUSTRIES
WA000301673Medicare PIN