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Contact Information

THIRD COAST VASCULAR SC
1441 N TAYLOR DR
SHEBOYGAN, WI53081-1989
 Phone: 262-577-0250
 Fax: 262-577-0251
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Undersea and Hyperbaric Medicine

207PE0005X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for THIRD COAST VASCULAR SC · (Female)

NPI # 1356085104
Status Active
Credentials
Entity Individual
Enumeration date 04/26/2022
Last updated 12/03/2025 - About 6 months 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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