NPI age
19 years
Enumerated 2006-06-13
● Active
Type 1 · Individual
DR. David MacY Vidrine, M.D.
Vidrine is 1 of 20 otolaryngology providers in Marietta and 1 of 450 in Georgia.
Primary specialty
Otolaryngology
Plus 2 subspecialties
Licensed in
GA, SC, MA
3 states
Status
Active
No deactivations on record
Last NPPES update
2026-05-04
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 450 active otolaryngology providers in Georgia.
NPI age
19 years
≈ at median (19 yr)
State licenses
3 states
Top 87% — 12% of peers are multi-state
Subspecialties
1
In the 30% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Practice location
80 Lacy St Nw
Marietta, GA 300601112
Mailing address
Po Box 23781
New York, NY 100873781
Specialties
-
Otolaryngology PrimaryAn otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures...
-
OtolaryngologyA pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | 301177 | |
| 01 (SC) | DE5192 | UNSPECIFIED |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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