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Individual

WYNTER K VIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5550 S EAST ST, STE I, INDIANAPOLIS, IN 46227-1979
(317) 780-4080
(317) 780-4088
Mailing address
250 N SHADELAND AVE, STE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01039294A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100118780
IN
Enumeration date
05/08/2006
Last updated
12/29/2020
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