Provider Demographics
NPI:1699334094
Name:HUNDERTMARK, VICTORIA ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ROSE
Last Name:HUNDERTMARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:ROSE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:MEDDAC-BAVARIA
Mailing Address - Street 2:PSC 411 UNIT 28037
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MEDDAC-BAVARIA
Practice Address - Street 2:PSC 411 UNIT 28037
Practice Address - City:APO
Practice Address - State:NY
Practice Address - Zip Code:09112
Practice Address - Country:US
Practice Address - Phone:314-569-4192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101270721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine