Organization
GREAT LAKES NEUROSURGICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YASHIIP SINGH PANNU MD (OWNER)
(414) 385-8702
Entity
Organization
Contact information
Practice address
2901 W KINNICKINNIC RIVER PARKWAY, SUITE 300, MILWAUKEE, WI 53215
(414) 385-8702
Mailing address
2901 W KINNICKINNIC RIVER PARKWAY, SUITE 300, MILWAUKEE, WI 53215
(414) 385-8702
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
45579-20
WI
207T00000X
Neurological Surgery Physician
—
—
Other
Enumeration date
10/09/2007
Last updated
05/17/2013
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