MEDICARE: AMY A KVIDERA MD

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	207Q00000X	Family Medicine Physician	40487	MN
2	207P00000X	Emergency Medicine Physician	40487	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639175896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY A KVIDERA MD

Provider Business Mailing Address
First Line	:	618 N 9TH ST
Second Line	:
City	:	SAINT PETER
State	:	MN
Zip	:	56082-1261
Country	:	US
Telephone Number	:	507-934-1211
Fax Number	:

Provider Business Practice Location Address
First Line	:	618 N 9TH ST
Second Line	:
City	:	SAINT PETER
State	:	MN
Zip	:	56082-1261
Country	:	US
Telephone Number	:	507-934-1211
Fax Number	:

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	08/21/2014

Similar Medicare Providers

1639138431 — KEITH D LARSON MD
Practice Location Address:

1511 NORTHWAY DR , SUITE 202
SAINT CLOUD, MN
56303-1261

Practice Phone: 320-217-8880
Practice Fax: 320-253-1822

1487691887 — DR. DENNIS LEE NIERENGARTEN D.D.S.
Practice Location Address:

1511 NORTHWAY DR , SUITE 102
SAINT CLOUD, MN
56303-1261

Practice Phone: 320-255-1020
Practice Fax: 320-255-1732

1811923659 — DR. MOHAMED SATTI YASSIN M.D.
Practice Location Address:

1511 NORTHWAY DR , SUITE 101
SAINT CLOUD, MN
56303-1261

Practice Phone: 320-654-8266
Practice Fax: 320-654-8481

1194813808 — DR. MARC DANA ORJANSEN DDS, MS
Practice Location Address:

1511 NORTHWAY DR , SUITE 202
SAINT CLOUD, MN
56303-1261

Practice Phone: 320-240-9028
Practice Fax: 320-240-9048

1982937827 — KEITH LARSON NEUROLOGY PLLC
Practice Location Address:

1511 NORTHWAY DR , SUITE 202
SAINT CLOUD, MN
56303-1261

Practice Phone: 320-217-8880
Practice Fax: 320-253-1822

1134463268 — ALISA BLACKWOOD CD(DONA)
Practice Location Address:

941 BRADFORD ST
SAINT PAUL, MN
55114-1261

Practice Phone: 612-618-8689
Practice Fax:

Directions to “ AMY A KVIDERA MD” 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.