Individual
EDUARDO A VIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00038051
WA
207R00000X
Internal Medicine Physician
Primary
OR-MD27304
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247628
—
OR
05
—
8252769
—
WA
01
—
P00418274
RAILROAD MEDICARE
OR
Enumeration date
12/27/2005
Last updated
12/29/2020
Update your record
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