Vidalakis, George E

Vidalakis, George E is an individual health care provider with primary practice located at 309 N Bartlett St , Shawano WI 54166-2127. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Vidalakis, George E can be contacted via phone (715) 526-2111.

Contact Information

Primary practice address
309 N Bartlett St Shawano WI 54166-2127
Fax: (715) 526-9174
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 25046 Wisconsin

Profile Details

NPI number 1598863334
LBN Legal business name Vidalakis, George E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jan 9th, 2016 - about 10 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 1598863334 NPPES
Wisconsin MEDICAID 31654000

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