Individual
ROGER A LALICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
721 AMERICAN AVE, SUITE 304, WAUKESHA, WI 53188-5071
(262) 549-2229
(262) 549-1657
Mailing address
721 AMERICAN AVE, SUITE 304, WAUKESHA, WI 53188-5071
(262) 549-2229
(262) 549-1657
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
21566
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30010700
—
WI
Enumeration date
10/26/2005
Last updated
08/17/2012
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