Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 58120 | MN |
NPI | 1104880822 |
---|---|
Provider Name | Veronica Mesquida |
First Address | Duluth, MN 55805-2297 |
Second Address | Duluth, MN 55805-2297 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 27/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036118514 | (05) | IL |
036118514 | ILLINIOS MD LICENSE (01) | IL |
200466110 | (05) | IN |
753210 | MEDICARE GROUP (01) | IL |
CF2064 | RAILROAD GROUP (01) | IL |
P00252724 | RAIL ROAD MEDICARE (01) | IN |