Individual
MR. NICHOLAS JOHN MODJESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3680
Mailing address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50915
MN
Other
Enumeration date
06/24/2006
Last updated
01/25/2012
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