Individual
DR. ABHISHEK SUNDARAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.B.B.S
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-1000
(262) 329-1001
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
68978
WI
2086S0129X
Vascular Surgery Physician
Primary
68978
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100078312
—
WI
Enumeration date
07/01/2009
Last updated
06/21/2024
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