Organization
JITENDRA K BARUAH MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JITENDRA K BARUAH MD (OWNER)
(414) 384-5581
Entity
Organization
Contact information
Practice address
3201 S 16TH ST, SUITE 200, MILWAUKEE, WI 53215-4537
(414) 384-5581
(414) 384-5644
Mailing address
19175 STILL POINT TRL, BROOKFIELD, WI 53045-4808
(414) 384-5581
(414) 384-5644
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30288000
—
WI
Enumeration date
05/15/2007
Last updated
09/15/2017
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