Individual
MICHAEL D VAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
130 S KNOWLES AVE, NEW RICHMOND, WI 54017-1727
(715) 246-3018
(715) 246-3019
Mailing address
130 S KNOWLES AVE, PO BOX 118, NEW RICHMOND, WI 54017-0118
(715) 246-3018
(715) 246-3019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
76740
MN
367500000X
Certified Registered Nurse Anesthetist
R-158100-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097N8VA
BLUE CROSS BLUE SHIELD
MN
05
—
929483000
—
MN
Enumeration date
09/27/2006
Last updated
04/18/2019
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