Provider Demographics
NPI:1275578882
Name:OUJEVOLK, AMERICA VICTORIA (MD)
Entity Type:Individual
Prefix:
First Name:AMERICA
Middle Name:VICTORIA
Last Name:OUJEVOLK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 661
Mailing Address - Street 2:
Mailing Address - City:LOVELOCK
Mailing Address - State:NV
Mailing Address - Zip Code:89419-0661
Mailing Address - Country:US
Mailing Address - Phone:775-273-2621
Mailing Address - Fax:775-273-3215
Practice Address - Street 1:855 6TH STREET
Practice Address - Street 2:
Practice Address - City:LOVELOCK
Practice Address - State:NV
Practice Address - Zip Code:89419
Practice Address - Country:US
Practice Address - Phone:775-273-2621
Practice Address - Fax:775-273-3215
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6403207Q00000X
CAG58900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G589000Medicaid
NV1447316310Medicaid
NV1447316310Medicaid
E28300Medicare UPIN