Individual
AJHANI KESAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1411 N TAYLOR DR, SHEBOYGAN, WI 53081-3043
(920) 496-4700
(603) 228-7307
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82441-20
WI
207Q00000X
Family Medicine Physician
RT-3658
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100252791
—
WI
Enumeration date
07/04/2020
Last updated
01/18/2024
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