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NPI Code Detail

MEDICARE: DR. KATHLEEN SULENTICH M.D./F.A.C.O.G.

MEDICARE:  DR. KATHLEEN  SULENTICH  M.D./F.A.C.O.G.
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
1174400000XSpecialist19781MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
129304SUOTHERMNBCBS

General Provider Information

NPI Number : 1831149046
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN SULENTICH M.D./F.A.C.O.G.
Provider Business Mailing Address
First Line : 3920 13TH AVE E
Second Line : SUITE 6
City : HIBBING
State : MN
Zip : 55746-3675
Country : US
Telephone Number : 218-263-7540
Fax Number : 866-732-0699
Provider Business Practice Location Address
First Line : 307 1ST ST S
Second Line : SUITE 112
City : VIRGINIA
State : MN
Zip : 55792-2696
Country : US
Telephone Number : 218-741-6221
Fax Number : 218-741-2550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 03/28/2008

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Directions to “ DR. KATHLEEN SULENTICH M.D./F.A.C.O.G.” Practice Location

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