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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982678553 NPPES
Wisconsin MEDICAID 31516400

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