Individual
MERRYN R JOLKOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38835
MN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
38835
MN
207RN0300X
Nephrology Physician
38835
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011481
PREFERRED ONE
—
01
—
110126975
RR MEDICARE
—
01
—
112147
UCARE
—
01
—
1616743
FIRST HEALTH PLAN
—
01
—
30T90JO
BLUE CROSS BLUE SHIELD
—
01
—
3100291 (PL)
MEDICA HEALTH PLANS
—
01
—
3107424
MEDICA HEALTH PLANS
—
01
—
600884
ARAZ GROUP AMERICAS PPO
—
01
—
926318700
MEDICAL ASSISTANCE
—
01
—
HP25459
HEALTH PARTNERS
—
Enumeration date
11/03/2005
Last updated
03/07/2023
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