Individual
NIKOLAI PETER MENDONCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
70748
MN
207R00000X
Internal Medicine Physician
ME143993
FL
208M00000X
Hospitalist Physician
66543
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/08/2014
Last updated
04/22/2022
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