Individual
PEDRO WILFRIDO VIVAR CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
848 N ST FRANCIS ST STE 3949, WICHITA, KS 67214-3859
(316) 268-8500
(316) 291-7993
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9667
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
04-37802
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201113500A
—
KS
Enumeration date
07/08/2010
Last updated
10/14/2021
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