Individual
DR. MARK ALAN VINING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF PEDIATRICS, WORCESTER, MA 01655-0002
(508) 334-2853
(508) 856-1042
Mailing address
UMASS MEMORIAL HEALTH, 55 LAKE AVENUE NORTH, WORCESTER, MA 01655
(774) 442-5139
(774) 443-2280
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
205146
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129780
—
MA
Enumeration date
11/15/2005
Last updated
09/20/2023
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