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Individual

DR. KUMAR R SANNAGOWDARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M D

Contact information

Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(414) 246-6800
(414) 246-6405
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 246-6800
(414) 246-6405

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
57263
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1063779601
WI
Enumeration date
04/20/2012
Last updated
08/11/2023
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