Individual
PHILIPPE VUYLSTEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 LIBERTY ST, BROCKTON, MA 02301-5674
(508) 941-7000
(508) 894-0412
Mailing address
110 LIBERTY ST, BROCKTON, MA 02301-5674
(508) 941-7000
(508) 894-0412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
225716
NY
207Q00000X
Family Medicine Physician
Primary
260995
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000402893001
BSH NE NY
NY
05
—
0231271
—
NY
01
—
10066238
CDPHP
NY
01
—
361196
MVP HEALTHPLAN
NY
Enumeration date
07/28/2006
Last updated
01/12/2024
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