Individual
THANMAYI KAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 S HERITAGE WOODS DR, APPLETON, WI 54915-1408
(920) 225-7875
(920) 993-5003
Mailing address
2600 S HERITAGE WOODS DR, APPLETON, WI 54915-1408
(920) 225-7875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
75570
WI
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
75570
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2017
Last updated
12/29/2021
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