Individual
GINOJ EDAKKUNNATHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1400 E BRADY ST, MILWAUKEE, WI 53202-1615
(414) 272-2171
Mailing address
1400 E BRADY ST, MILWAUKEE, WI 53202-1615
(414) 272-2171
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051.293353
IL
183500000X
Pharmacist
Primary
15612-040
WI
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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