Organization
EXCELLENCE DIABETES ENDOCRINOLOGY & METABOLISM CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILFRED M VICTORINA MD (OWNER)
(859) 496-1803
Entity
Organization
Contact information
Practice address
1000 N FRONT ST, SUITE 400, WORMLEYSBURG, PA 17043-1034
(717) 695-6741
(717) 695-6768
Mailing address
1000 N FRONT ST, SUITE 400, WORMLEYSBURG, PA 17043-1034
(717) 695-6741
(717) 695-6768
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD432714
PA
Other
Enumeration date
05/09/2009
Last updated
06/26/2015
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