Individual
NATHAN KUTTICKAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-7136
(414) 219-6264
Mailing address
519 E CEDAR LN, MEQUON, WI 53092-6104
(920) 889-0912
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
81961-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2023
Last updated
07/19/2025
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