Individual
VASAVI KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1111 DELAFIELD ST, STE 209, WAUKESHA, WI 53188
(262) 542-0444
(262) 542-8214
Mailing address
1111 DELAFIELD ST, STE 209, WAUKESHA, WI 53188-3403
(262) 542-0444
(262) 542-8214
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1000-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063408334
—
WI
Enumeration date
09/22/2005
Last updated
08/22/2022
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