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General NPI Number Information
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NPI Number | 1912801945
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Entity Type | Organization
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Legal Business Name | MVP VISION GROUP, S.C.
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 9815 HWY 70 STE 102
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City | MINOCQUA
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State | WI
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Zip | 54548-9769
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Country | US
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Telephone | 715-358-3937
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Fax | 715-358-7677
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Provider Business Mailing Address
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Address Line | 16800 W CLEVELAND AVE
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City | NEW BERLIN
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State | WI
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Zip | 53151-3533
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Country | US
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Telephone | 630-335-3043
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Fax | 630-225-7515
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL H BASTERMAJIAN
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Credential | OD
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Telephone | 630-335-3043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | NULL
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