Organization
VALLEY UROLOGIC ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ELMER VLACH JR. M.D. (PRESIDENT)
(920) 739-3537
Entity
Organization
Contact information
Practice address
800 RIVERSIDE DR, RIVERSIDE MEDICAL CENTER WAUPACA, WAUPACA, WI 54981-1943
(920) 739-3537
Mailing address
820 E GRANT ST, APPLETON, WI 54911-3483
(920) 739-3537
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32748300
—
WI
01
—
989963
UNITED HEALTHCARE
WI
Enumeration date
03/23/2007
Last updated
08/22/2020
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