Organization
VALLEY UROLOGIC ASSOCIATES, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E VLACH JR. MD (PRESIDENT)
(920) 739-3537
Entity
Organization
Contact information
Practice address
100 COUNTY ROAD B, SHAWANO, WI 54166
(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
03/26/2007
Last updated
08/22/2020
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