Individual
DR. JOHN L WACIUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6122
(715) 717-6600
Mailing address
900 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6122
(715) 717-6600
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
43260
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1985253
HIGHMARK BLUE SHIELD
PA
05
—
440057700
—
MN
01
—
822242
FIRST PRIORITY HEALTH
PA
Enumeration date
02/02/2006
Last updated
05/16/2012
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