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Individual

DR. KATHLEEN SULENTICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D./F.A.C.O.G.

Contact information

Practice address
307 1ST ST S, SUITE 112, VIRGINIA, MN 55792-2696
(218) 741-6221
(218) 741-2550
Mailing address
3920 13TH AVE E, SUITE 6, HIBBING, MN 55746-3675
(218) 263-7540
(866) 732-0699

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19781
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29304SU
BCBS
MN
Enumeration date
05/10/2006
Last updated
03/28/2008
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