Vanblarcom, Stephen Thaddeus
Vanblarcom, Stephen Thaddeus is an individual health care provider with primary practice located at 10400 W North Avenue Suite 300, Milwaukee WI 53214. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Vanblarcom, Stephen Thaddeus can be contacted via phone (414) 771-7470.Contact Information
Primary practice address
10400 W North Avenue Suite 300
Milwaukee WI 53214
Phone: (414) 771-7470
Fax: (414) 771-7433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 28611-020 | Wisconsin |
Profile Details
| NPI number | 1982678553 |
|---|---|
| LBN Legal business name | Vanblarcom, Stephen Thaddeus |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Nov 30th, 2021 - about 3 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 | 1982678553 | NPPES |
| Wisconsin | MEDICAID | 31516400 |
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