Individual
MR. STEPHEN VIDMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
6200 W BLUEMOUND RD, MILWAUKEE, WI 53213-4145
(414) 771-5600
(414) 476-9988
Mailing address
6200 W BLUEMOUND RD, MILWAUKEE, WI 53213-4145
(414) 771-5600
(414) 476-9988
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
157404-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157404-30
RN STATE LICENSE
WI
Enumeration date
03/24/2008
Last updated
03/24/2008
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