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Individual

ANTHONY VIDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
615 N MICHIGAN ST 1ST FL HOSPITALIST STE, SOUTH BEND, IN 46601-1033
(574) 647-3050
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01082175A
IN
207Q00000X
Family Medicine Physician
4301105211
MI
208M00000X
Hospitalist Physician
01082175A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300027549
IN
Enumeration date
05/16/2014
Last updated
03/30/2026
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