Basic Information
Provider Information
NPI: 1174729081
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VYAS
FirstName: UMESH
MiddleName: KUMAR
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 900 ILLINOIS AVE
Address2:  
City: STEVENS POINT
State: WI
PostalCode: 544813114
CountryCode: US
TelephoneNumber: 7153465000
FaxNumber:  
Practice Location
Address1: 900 ILLINOIS AVE
Address2:  
City: STEVENS POINT
State: WI
PostalCode: 544813114
CountryCode: US
TelephoneNumber: 7153465000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2007
LastUpdateDate: 09/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X53554WIY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084S0012X53225MNN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine

No ID Information.


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