Individual
RAM K MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 15TH AVENUE, SUIT 170, SOUTH MILWAUKEE, WI 53172
(414) 762-3910
(414) 762-9694
Mailing address
PO BOX 935, HALES CORNERS, WI 53130-0935
(414) 762-3910
(414) 762-9694
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20701
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30152400
—
WI
Enumeration date
11/29/2006
Last updated
11/02/2012
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