Individual
MICHAEL P VEZERIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 DUDLEY ST, SUITE 470, PROVIDENCE, RI 02905-3236
(401) 331-1036
(401) 868-2317
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD06270
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9006495
—
RI
Enumeration date
11/16/2005
Last updated
01/29/2020
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