Provider Demographics
NPI:1528051471
Name:VLAD, JOHN OVID (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:OVID
Last Name:VLAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6105
Mailing Address - Country:US
Mailing Address - Phone:330-841-7332
Mailing Address - Fax:330-841-7329
Practice Address - Street 1:2219 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6105
Practice Address - Country:US
Practice Address - Phone:330-841-7332
Practice Address - Fax:330-841-7329
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35024361V208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0048460Medicaid
OH0048460Medicaid
OH341236530-00Medicare ID - Type Unspecified