Individual
DR. DANIEL EVAN VIDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
207 SOUTHBRIDGE ST, AUBURN, MA 01501-2548
(508) 832-7118
(508) 832-4758
Mailing address
207 SOUTHBRIDGE ST, AUBURN, MA 01501-2548
(508) 832-7118
(508) 832-7166
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
042219
CT
207N00000X
Dermatology Physician
11477
RI
207N00000X
Dermatology Physician
Primary
75666
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000028685
BMC HEALTH NET
MA
01
—
001422196
TITLE 19 INS
CT
01
—
00142219600
BLUE CARE FAMILY
CT
01
—
010042219CT02
ANTHEM BC BS
CT
01
—
010075666M02
ANTHEM BC BS
MA
01
—
0303009
UNITED HEALTH PLANS
MA
01
—
043158835
COMMERCIAL
MA
01
—
075666
TUFTS MASS
MA
01
—
17462
HEALTH OF NEW ENGLAND
MA
01
—
2V2311
HEALTH NET
CT
05
—
3092917
—
MA
01
—
4294
HARVARD PILGRIM
MA
01
—
620067
US HEALTH CARE
MA
01
—
758835
CONNECTICARE
CT
01
—
997001
NETWORK HEALTH
MA
01
—
J12248
BC BS OF MASS
MA
01
—
P1705911
OXFORD HEALTH PLANS
CT
Enumeration date
08/25/2005
Last updated
11/28/2023
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