Organization
VITUITY-WISCONSIN EM SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BIRDSALL (VICE PRESIDENT AND SECRETARY)
(510) 350-2759
Entity
Organization
Contact information
Practice address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8000
Mailing address
2100 POWELL ST STE 400, EMERYVILLE, CA 94608-1872
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
06/27/2023
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