Individual
VIKTORIYA V. VLADYKINA
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) 251-2700
(320) 240-3164
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 251-2700
(320) 240-3164
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PERMIT22871
MN
208M00000X
Hospitalist Physician
Primary
55494
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780993345
—
MN
Enumeration date
09/30/2010
Last updated
10/30/2015
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