Individual
MARY ELLEN LOUISE VOMACKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1604 SOUTH FIRST STREET, AFFILIATED COMMUNITY MEDICAL CENTERS, WILLMAR, MN 56201
(320) 231-5079
(320) 231-5067
Mailing address
1604 SOUTH FIRST STREET, AFFILIATED COMMUNITY MEDICAL CENTERS, WILLMAR, MN 56201
(320) 231-5079
(320) 231-5067
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
36746
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013089
PREFERRED ONE
—
01
—
115359
UCARE
—
01
—
1521082
UBH
—
01
—
9F414VO
BLUE CROSS
—
Enumeration date
12/06/2006
Last updated
06/14/2013
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