Individual
VICTORIA L POTOCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3618 S 4TH ST, TERRE HAUTE, IN 47802-5543
(812) 238-8887
(812) 238-9166
Mailing address
3618 S 4TH ST, TERRE HAUTE, IN 47802-5543
(812) 238-8887
(812) 238-9166
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
01043236
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093386
BLUE SHIELD
IN
05
—
200157540
—
IN
Enumeration date
06/22/2006
Last updated
10/10/2015
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