Individual
VICENTIU ANDREI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11134 N HWY 77, HAYWARD, WI 54843
(715) 634-5505
Mailing address
11134 N HWY 77, HAYWARD, WI 54843
(715) 634-5505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
36760-020
WI
208600000X
Surgery Physician
Primary
36760-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32310200
—
WI
Enumeration date
06/26/2006
Last updated
05/06/2011
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