Individual
VIKTOR VASILYEVICH FEDOROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
255 MEMORIAL DR, JACKSONVILLE, NC 28546-6333
(910) 353-7848
Mailing address
255 MEMORIAL DR, JACKSONVILLE, NC 28546-6333
(910) 353-7848
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2024-01637
NC
390200000X
Student in an Organized Health Care Education/Training Program
218430
NC
Other
Enumeration date
04/03/2016
Last updated
12/27/2024
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