Provider Demographics
NPI:1508028770
Name:VIKSJO, MICHAEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:VIKSJO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1308 MORRIS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3328
Mailing Address - Country:US
Mailing Address - Phone:908-851-2770
Mailing Address - Fax:908-851-9023
Practice Address - Street 1:1308 MORRIS AVE STE 102
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3328
Practice Address - Country:US
Practice Address - Phone:908-851-2770
Practice Address - Fax:908-851-9023
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2023-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08505500207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology