Wireko-Brobby, Vivian Lilly

Wireko-Brobby, Vivian Lilly is an individual health care provider with primary practice located at 1540 Lake St S , Forest Lake MN 55025-2628. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wireko-Brobby, Vivian Lilly can be contacted via phone (651) 464-7100.

Contact Information

Primary practice address
1540 Lake St S Forest Lake MN 55025-2628
Phone: (651) 464-7100
Fax: (651) 241-1515
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101245308 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 139432 District of Columbia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 57354 Minnesota

Profile Details

NPI number 1033393178
LBN Legal business name Wireko-Brobby, Vivian Lilly
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2007
Last updated Nov 10th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033393178 NPPES
Minnesota MEDICAID 1033393178

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