Individual
MICHAEL C VIDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
403 SUMMIT BLVD, BROOMFIELD, CO 80021-8252
(720) 401-2139
(303) 469-4439
Mailing address
403 SUMMIT BLVD, BROOMFIELD, CO 80021-8252
(720) 401-2139
(303) 469-4439
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
DR.0031693
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7215792
BCBS
—
Enumeration date
02/01/2006
Last updated
08/21/2014
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