Individual
JULIA GABRIELA VASQUEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501
(218) 847-5611
(218) 844-2444
Mailing address
400 EAST THIRD STREET MCL2CRED, DULUTH, MN 55805-1951
(218) 786-3146
(218) 722-8792
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
63308
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2013
Last updated
07/11/2018
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