Individual
JERROLD L VITEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 DELAWARE STREET SE, UMP NEUROLOGY CLINIC, MINNEAPOLIS, MN 55455
(612) 672-7422
Mailing address
720 WASHINGTON AVE SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55414
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
35084656
OH
2084N0400X
Neurology Physician
Primary
53507
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2496017
—
OH
Enumeration date
04/18/2006
Last updated
04/16/2014
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