Individual
VIVIAN MARIE MINKEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3400 WAKE FOREST RD, RALEIGH, NC 27609-7317
(919) 954-3624
Mailing address
3400 WAKE FOREST RD, RALEIGH, NC 27609-7317
(919) 954-3624
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2021-01121
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2017
Last updated
08/17/2023
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