Organization
RADIOLOGY ASSOCIATES OF WAUSAU, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN C STANLEY (AUTHORIZED OFFICIAL)
(715) 847-2283
Entity
Organization
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSAU, WI 54401
(715) 847-2283
Mailing address
PO BOX 1665, EVANSVILLE, IN 47706-0066
(715) 847-2283
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104662891
MI MEDICAID
MI
05
—
32665300
—
WI
Enumeration date
07/29/2006
Last updated
07/10/2025
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