Provider Demographics
NPI:1326004706
Name:STOIK, VAIDA M (MD)
Entity type:Individual
Prefix:DR
First Name:VAIDA
Middle Name:M
Last Name:STOIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VAIDA
Other - Middle Name:M
Other - Last Name:MACIUTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2845 GREENBRIER RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6519
Mailing Address - Country:US
Mailing Address - Phone:920-288-8100
Mailing Address - Fax:
Practice Address - Street 1:2845 GREENBRIER RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-6519
Practice Address - Country:US
Practice Address - Phone:920-288-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2008-0204207R00000X, 207RR0500X
WI63455207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099598002Medicare PIN
NMNMB2172Medicare PIN