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Individual

MARY KAY VASKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
103092
MN
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
2009012968
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
077115000
MN
05
1043416464
MO
01
P00740243
RAILROAD MEDICARE
Enumeration date
06/22/2007
Last updated
05/15/2013
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