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General NPI Number Information
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NPI Number | 1891744652
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Entity Type | Individual
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Provider Name | MIHAILO LALICH MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 3802 OAKWOOD MALL DR
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City | EAU CLAIRE
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State | WI
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Zip | 54701-3016
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Country | US
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Telephone | 715-839-9280
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Fax |
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Provider Business Mailing Address
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Address Line | 719 W HAMILTON AVE STE B
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6970
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Country | US
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Telephone | 715-552-6589
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Fax | 715-835-6370
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 49785
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 46134
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License Number State | WI
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