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Individual
NICHOLAS BRIAN VIDOR
Active
Individual
NICHOLAS BRIAN VIDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55493
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001-0100257
MEDICA
—
01
—
1063704914
BCBS
MN
05
—
1063704914
—
MN
01
—
P01099801
RR MEDICARE
MN
Enumeration date
05/11/2011
Last updated
11/19/2025
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