Shanna Rachelle Vidor, M.D.

NPI #1215229729 in Nett Lake, Minnesota

Provider Information

NPI Number: 1215229729
Entity Type: Individual
Name: Shanna Rachelle Vidor, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: May 3, 2011
Last Updated: Jun 18, 2020

Practice Location

Address: 5219 ST JOHN DRIVE
City: Nett Lake
State: Minnesota
ZIP Code: 55772-8232
Phone: (218) 757-3295

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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