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General NPI Number Information
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NPI Number | 1588841605
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Entity Type | Organization
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Legal Business Name | VICTOR W. CACERES, M.D.,S.C.
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 919 S. UNIVERSITY AVENUE
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City | BEAVER DAM
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State | WI
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Zip | 53916-3001
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Country | US
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Telephone | 920-885-9238
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Fax | 920-885-4405
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Provider Business Mailing Address
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Address Line | 919 S UNIVERSITY AVE
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City | BEAVER DAM
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State | WI
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Zip | 53916-3001
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Country | US
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Telephone | 920-885-9238
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Fax | 920-885-4405
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JOYCE THOMPSON
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Credential |
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Telephone | 920-885-9238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 20274
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License Number State | WI
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