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Individual

DR. TERESA ANGELA VENDITTO ST GEORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3605 MAYFAIR AVE, HIBBING, MN 55746-2923
(218) 262-3441
(218) 362-6989
Mailing address
3605 MAYFAIR AVE, HIBBING, MN 55746-2923
(218) 262-3441
(218) 362-6989

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
46867
MN
207Q00000X
Family Medicine Physician
Primary
46867
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080015131
MEDICARE
MN
05
452433100
MN
Enumeration date
05/13/2006
Last updated
09/23/2013
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