Organization
VITUITY-WISCONSIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BIRDSALL MD (VICE PRESIDENT AND SECRETARY)
(510) 350-2600
Entity
Organization
Contact information
Practice address
10256 OLD GREEN BAY RD STE 140, PLEASANT PRAIRIE, WI 53158-2814
(262) 217-3455
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
09/12/2023
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