Individual
DANA I VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8420
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37135
WI
207R00000X
Internal Medicine Physician
Primary
60822
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110143300
RAILROAD MEDICARE
WI
05
—
32339500
—
WI
Enumeration date
11/22/2005
Last updated
01/29/2021
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