Individual
PROF. KONDRAGUNTA RAJENDRA PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVENUE, MILWAUKEE, WI 53226-3522
(414) 805-6400
(414) 955-0213
Mailing address
9200 W WISCONSIN AVENUE, MILWAUKEE, WI 53226-3522
(414) 805-6400
(414) 955-0213
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
9-876
WI
2086X0206X
Surgical Oncology Physician
9-876
WI
Other
Enumeration date
05/02/2023
Last updated
05/08/2023
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