DR. GEORGE E VIDALAKIS


Address: 309 N Bartlett St, Shawano, WI 54166-2127
Phone: 7155262111

DR. GEORGE E VIDALAKIS (NPI# 1598863334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598863334
Entity Type Individual
Full Name DR. GEORGE E VIDALAKIS
Credential M.D.
Practice Address 309 N Bartlett St
Shawano
WI 54166-2127
Mailing Address 100 County Road B
Shawano
WI 54166-7072
Practice Telephone 7155262111
Practice Fax Number 7155269174
Mailing Telephone 7155268120
Mailing Fax Number 7155269174
Enumeration Date 2006-09-20
Last Update Date 2016-01-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207PE0004X Emergency Medicine
Specialization: Emergency Medical Services
25046 WI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI 31654000 05

Office Location

Street Address 309 N BARTLETT ST
City SHAWANO
State WI
Zip Code 54166-2127

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609877505 Robert R Eastman Family Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2005-08-02
1336525526 Elle Kosciuk Specialist/Technologist 309 N Bartlett St, Shawano, WI 54166-2127 2015-08-11
1952684607 Sharisa M Ruh Physician Assistant 309 N Bartlett St, Shawano, WI 54166-2127 2011-09-20
1508155474 Forefront Dermatology, S.c. Dermatology 309 N Bartlett St, Shawano, WI 54166 2011-03-31
1265731590 Paul Michael Theuerkauf Physical Therapist 309 N Bartlett St, Shawano, WI 54166-2127 2011-03-25
1942430996 Sheila M Landon Nurse Practitioner 309 N Bartlett St, Shawano, WI 54166-2127 2009-07-23
1669563763 Scott A Hathaway Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-27
1639279383 Rajeshwar Hanmiah Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-23
1780670034 Tony O Sandstrom Anesthesiology 309 N Bartlett St, Shawano, WI 54166-2127 2005-09-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134641848 Nicole Jeannine Klotzbuecher Optometrist 150 County Road B, Shawano, WI 54166 2017-07-13
1437605714 Jennifer Marie Franke Counselor 504 Lakeland St, Shawano, WI 54166 2016-08-28
1699017913 Benjamin D Schlais Family Medicine 100 County Hwy B, Shawano, WI 54166 2013-03-25
1154574366 Luke T Johnson Speech-Language Pathologist N3684 River Road, Shawano, WI 54166 2008-10-31
1902054315 Robert Joseph Bohr Jr. Physical Therapy Assistant N6590 Fox Lane, Shawano, WI 54166 2008-08-28
1790945863 Patricia Rae Ainsworth Physical Therapist 1436 South Lincoln Street, Shawano, WI 54166 2008-06-12
1649491820 Shawano-gresham School District Local Education Agency (LEA) 1050 South Union Street, Shawano, WI 54166 2007-05-02
1114043387 Thomas G Peterson Optometrist 150a County Road B, Shawano, WI 54166 2007-03-21
1740343086 John Milton Dovorany Dentist 1488 E Green Bay St, Shawano, WI 54166 2006-12-18
1265526305 Charles E Lamarche Counselor 420 E Green Bay St, Ste 201, Shawano, WI 54166 2006-10-03
Find all providers in zip 54166

Taxonomy Information

Taxonomy Code 207PE0004X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine
Specialization Emergency Medical Services

Taxonomy Definition

An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669563763 Scott A Hathaway Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-27
1639279383 Rajeshwar Hanmiah Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144703653 Quinton Jarrett Peters Emergency Medicine 1204 S Jefferson St, Appleton, WI 54915-1726 2018-09-11
1497792139 John A Culp Emergency Medicine 1446 N Randall Ave, Janesville, WI 53545-1122 2006-06-01
1861440505 Alice C Bustos Emergency Medicine 7220 W National Ave, West Allis, WI 53214-4734 2006-05-05
1184690133 Manuel A. Rivera Emergency Medicine 5000 Memorial Dr, Two Rivers, WI 54241-3900 2006-02-28
1942588132 Watertown Regional Medical Center, Inc Emergency Medicine 125 Hospital Dr, Watertown, WI 53098-3303 2011-07-22
1366692287 James John Macneal Emergency Medicine 1000 Mineral Point Ave, Janesville, WI 53548-2940 2008-09-28
1770646721 Larry R Brunzlick Emergency Medicine 135 South Gibson Street, Medford, WI 54451 2006-12-19
1548378367 John Malcolm Mckichan Emergency Medicine 11040 N State Road 77, Hayward, WI 54843-6391 2006-08-29
1669407649 Mohammad Dodwad Emergency Medicine 900 College Ave W, Ladysmith, WI 54848-2116 2006-07-11
1023047859 Richard Mayrer Emergency Medicine 2251 N Shore Dr, Rhinelander, WI 54501-8360 2006-07-02
Find all providers with the same taxonomy

Competitor

Search similar providers

City SHAWANO
Zip Code 54166

Improve Information

Please comment or provide details below to improve the information on DR. GEORGE E VIDALAKIS.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches