MEDICARE: MR. VICTOR SERGEI GROMOFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0200X	Critical Care Medicine Registered Nurse	200845	ND

General Provider Information

NPI Number	:	1225865454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VICTOR SERGEI GROMOFF

Provider Business Mailing Address
First Line	:	3715 UNIVERSITY AVE APT 207
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58203-0578
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3715 UNIVERSITY AVE APT 207
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58203-0578
Country	:	US
Telephone Number	:	952-905-4570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2024
Last Update Date	:	09/19/2024

Similar Medicare Providers

1972534469 — TOWNSHIP OF LELAND
Practice Location Address:

201 GRAND AVENUE
LELAND, MI
49654-0578

Practice Phone: 231-256-7546
Practice Fax: 231-256-2465

1962335091 — MERCEDES CAELWAERTS
Practice Location Address:

725 HAMLINE ST STE 1200
GRAND FORKS, ND
58203-2819

Practice Phone: 701-780-6800
Practice Fax:

1629637624 — DR. RACHEL LEEANN BUSKO MD
Practice Location Address:

725 HAMLINE ST
GRAND FORKS, ND
58203-2819

Practice Phone: 701-780-6827
Practice Fax:

1801532171 — RYLEE M VENN DO
Practice Location Address:

725 HAMLINE ST
GRAND FORKS, ND
58203-2819

Practice Phone: 701-708-6800
Practice Fax:

1861326985 — JOSIE LYNN WUTZKE
Practice Location Address:

1605 9TH AVE N
GRAND FORKS, ND
58203-0711

Practice Phone: 701-732-1248
Practice Fax:

1205055506 — MAUREEN LOUISE RILEY MPT
Practice Location Address:

1628 LEWIS BLVD
GRAND FORKS, ND
58203-1639

Practice Phone: 218-779-3779
Practice Fax:

Directions to “ MR. VICTOR SERGEI GROMOFF ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.