Bakalars, Mark Glen
Bakalars, Mark Glen is an individual health care provider with primary practice located at 725 American Ave , Waukesha WI 53188-5031. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Bakalars, Mark Glen can be contacted via phone (262) 928-2400.Contact Information
Primary practice address
725 American Ave
Waukesha WI 53188-5031
Phone: (262) 928-2400
Fax: (262) 928-7621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 40309-020 | Wisconsin |
Profile Details
| NPI number | 1174518724 |
|---|---|
| LBN Legal business name | Bakalars, Mark Glen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174518724 | NPPES |
| Wisconsin | MEDICAID | 34340500 |
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