Individual
VISHNU VARDHAN R PATLOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 BELLINGER ST, EAU CLAIRE, WI 54703-5222
(715) 838-5222
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
227566
MA
207RC0000X
Cardiovascular Disease Physician
Primary
55823
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720187933
—
WI
Enumeration date
09/22/2006
Last updated
09/10/2020
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