Individual
VIVEK BALASUBRAMANIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-6420
(608) 263-0440
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
62982-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01373430
—
CO
Enumeration date
10/25/2006
Last updated
01/11/2021
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