Individual
SUNIL J VAIDYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
391 GLESSNER AVE, MANSFIELD, OH 44903-2107
(419) 520-2813
(419) 756-9797
Mailing address
744 COURTWRIGHT BLVD, MANSFIELD, OH 44907-2220
(419) 520-2813
(419) 756-9797
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.059862
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35.059862
OH
207RP1001X
Pulmonary Disease Physician
Primary
35.059862
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0823890
—
OH
Enumeration date
06/12/2006
Last updated
12/18/2020
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