Provider Demographics
NPI:1073564266
Name:VICKEN VORPERIAN, MD
Entity Type:Organization
Organization Name:VICKEN VORPERIAN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICKEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:VORPERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-928-8300
Mailing Address - Street 1:721 AMERICAN AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-5071
Mailing Address - Country:US
Mailing Address - Phone:262-548-3600
Mailing Address - Fax:262-548-3539
Practice Address - Street 1:721 AMERICAN AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5071
Practice Address - Country:US
Practice Address - Phone:262-548-3600
Practice Address - Fax:262-548-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31942600Medicaid