Individual
VINCENT J KOLETAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2478 13TH ST SE, SALEM, OR 97302-2546
(503) 362-2481
(503) 371-7803
Mailing address
2478 13TH ST SE, SALEM, OR 97302-2546
(503) 362-2481
(503) 371-7803
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD18845
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133940
—
OR
Enumeration date
09/12/2005
Last updated
04/23/2008
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