Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 35300 | MN |
NPI | 1003921586 |
---|---|
Provider Name | Dr. Vicki Meyer Oster |
First Address | Edina, MN 55435-5655 |
Second Address | Eden Prairie, MN 55347-1180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1200003 | MEDICA (01) | MN |
4T689OS | BC/BS (01) | MN |
F58250 | (02) | MN |
FP9021001150 | PREFERRED ONE (01) | MN |