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Individual

JAYANTH G. VEDRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
50086-020
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
50086
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
51817
MN
207RP1001X
Pulmonary Disease Physician
50086
WI

Other

Enumeration date
06/27/2007
Last updated
09/25/2012
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