Vanessa Michalicka, DO | |
515 22nd Ave, Monroe, WI 53566-1569 | |
(608) 324-2000 | |
Not Available |
Full Name | Vanessa Michalicka |
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Gender | Female |
Speciality | Surgery |
Location | 515 22nd Ave, Monroe, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831630631 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 5101023023 (Michigan) | Secondary |
208600000X | Surgery | 23187 (Wisconsin) | Primary |
Entity Name | The Monroe Clinic Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386720548 PECOS PAC ID: 3072425495 Enrollment ID: O20031104000392 |
Mailing Address | Practice Location Address |
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Vanessa Michalicka, DO 8333 Biddle Ave, Henry Ford Wyandotte Hospital, Wyandotte, MI 48192 Ph: (734) 246-7086 | Vanessa Michalicka, DO 515 22nd Ave, Monroe, WI 53566-1569 Ph: (608) 324-2000 |
Richard Huntsman, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 515 22nd Avenue, Monroe, WI 53566 Phone: 608-324-2000 | |
Dr. Mohammad Shirdel Gerdvisheh, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 515 22nd Ave, Monroe, WI 53566 Phone: 608-324-2000 | |
Nicholas P Maxwell, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 515 22nd Ave, Monroe, WI 53566 Phone: 608-324-2000 |