Organization
RETINA & VITREOUS CONSULTANTS OF WI, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARATH C RAJA MD (PRESIDENT)
(414) 774-3484
Entity
Organization
Contact information
Practice address
2600 N MAYFAIR RD, SUITE 901, MILWAUKEE, WI 53226-1309
(414) 774-3484
(414) 778-3445
Mailing address
2600 N MAYFAIR RD, SUITE 901, MILWAUKEE, WI 53226-1309
(414) 774-3484
(414) 778-3445
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32708400
—
WI
Enumeration date
03/23/2007
Last updated
06/23/2021
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