Provider Demographics
NPI:1053384339
Name:ESSWEIN, VIVIAN E (MD)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:E
Last Name:ESSWEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-6232
Mailing Address - Country:US
Mailing Address - Phone:508-992-6553
Mailing Address - Fax:508-990-7558
Practice Address - Street 1:874 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6232
Practice Address - Country:US
Practice Address - Phone:508-992-6553
Practice Address - Fax:508-990-7558
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50273208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000024044OtherBMC HEALTHNET
MA20239OtherHARVARD PILGRIM
MA96056301OtherNETWORK HEALTH
MAB10423501OtherCIGNA
MA0001371OtherNEIGHBORHOOD HEALTH PLAN
MA1201078OtherUNITED HEALTH
RI205627OtherBCBSRI
MA3015122Medicaid
RI402515OtherBCBSBLUECHIP
MA5125930001OtherCIGNA PAL
MA776391OtherTUFTS HEALTH PLAN
MAJ03631OtherBCBSMA
MA0820623OtherAETNA
MA23821OtherCMSP
MAMA0018229OtherTRICARE
MA3015122Medicaid
MA776391OtherTUFTS HEALTH PLAN