| Blaise Paul Vitale, MD | |
|
257 W Saint George Ave, Grantsburg, WI 54840-7827 | |
| (715) 463-5317 | |
| (715) 463-2753 |
| Full Name | Blaise Paul Vitale |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 38 Years |
| Location | 257 W Saint George Ave, Grantsburg, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487713723 | NPI | - | NPPES |
| 31761500 | Medicaid | WI | |
| 660085900 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 32065 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Burnett Medical Center Inc | Grantsburg, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Burnett Medical Center Inc | 2163314931 | 19 |
| Entity Name | Burnett Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356499784 PECOS PAC ID: 2163314931 Enrollment ID: O20040326000457 |
| Mailing Address | Practice Location Address |
|---|---|
| Blaise Paul Vitale, MD 257 W Saint George Ave, Grantsburg, WI 54840-7827 Ph: (715) 463-5353 | Blaise Paul Vitale, MD 257 W Saint George Ave, Grantsburg, WI 54840-7827 Ph: (715) 463-5317 |
Adeola A Jolayemi, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 257 W Saint George Ave, Grantsburg, WI 54840 Phone: 715-463-5317 Fax: 715-463-7335 | |
Timothy George Novick, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 257 W Saint George Ave, Grantsburg, WI 54840 Phone: 715-463-5353 Fax: 715-463-2753 | |
Vesna Radivojevic, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 257 W Saint George Ave, Grantsburg, WI 54840 Phone: 715-463-5317 Fax: 715-463-2753 | |
David A Lang, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 257 W Saint George Ave, Grantsburg, WI 54840 Phone: 715-463-5353 |