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Contact Information

CTVSA WISCONSIN S.C.
6308 8TH AVE
SUITE 3060
KENOSHA, WI53143-5031
 Phone: 262-656-2700
 Fax: 262-656-3672
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
 

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for CTVSA WISCONSIN SC · (Female)

NPI # 1225318090
Status Active
Credentials
Entity Individual
Enumeration date 08/24/2011
Last updated 08/24/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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