Individual
DR. EREZ VIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3850
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
1015001
MA
2085R0202X
Diagnostic Radiology Physician
0101259946
VA
2085R0202X
Diagnostic Radiology Physician
Primary
1015001
MA
2085R0202X
Diagnostic Radiology Physician
238696
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2007
Last updated
02/19/2026
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