Individual
VASUNDHARA GANNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3120 SOUTH 27TH STREET, MILWAUKEE, WI 53215
(414) 672-8282
(414) 672-8284
Mailing address
335 MAHN COURT, OAK CREEK, WI 53154
(414) 762-2020
(414) 762-2024
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
43101
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053303057
—
WI
05
—
34422600
—
WI
Enumeration date
08/17/2005
Last updated
01/17/2022
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