Provider Demographics
NPI:1831455856
Name:SALVADOR, VINCENT BRYAN D (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT BRYAN
Middle Name:D
Last Name:SALVADOR
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 1:4260 PLYMOUTH RD # B1-313
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-2700
Mailing Address - Country:US
Mailing Address - Phone:734-232-0305
Mailing Address - Fax:734-647-8348
Practice Address - Street 1:4260 PLYMOUTH RD # B1-313
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-2700
Practice Address - Country:US
Practice Address - Phone:734-232-0305
Practice Address - Fax:734-647-8348
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP05709390200000X
MI4301511168207R00000X
WAMD60454306207R00000X
IL036155204207R00000X
OH57.254090390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program