Individual
PRADEEP GOPI KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8400 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3735
(262) 884-4000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
41877
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32632100
—
WI
Enumeration date
06/09/2006
Last updated
11/06/2023
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