Individual
JAMES ROBERT VAVRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2835 N GRANDVIEW BLVD STE 300, PEWAUKEE, WI 53072-5591
(262) 542-3779
(262) 542-4428
Mailing address
2835 N GRANDVIEW BLVD STE 300, PEWAUKEE, WI 53072-5591
(262) 542-3779
(262) 542-4428
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
696
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43219700
—
WI
Enumeration date
08/18/2005
Last updated
02/21/2022
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