Individual
DR. VIVEK SURESHCHANDRAN THARAYIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS, FRACP
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
30583
MN
390200000X
Student in an Organized Health Care Education/Training Program
207RG0100X
—
Other
Enumeration date
10/27/2020
Last updated
08/03/2021
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