Provider Demographics
NPI:1750788493
Name:VIELIE, SHELDON (RPH)
Entity type:Individual
Prefix:MR
First Name:SHELDON
Middle Name:
Last Name:VIELIE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 S GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53406-4950
Mailing Address - Country:US
Mailing Address - Phone:262-554-1116
Mailing Address - Fax:262-554-1162
Practice Address - Street 1:2820 S GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-4950
Practice Address - Country:US
Practice Address - Phone:262-554-1116
Practice Address - Fax:262-554-1162
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist