Individual
MRS. PRASHANTI SHIVARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
7400 W RAWSON AVE, SUITE 225, FRANKLIN, WI 53132-8278
(414) 425-8232
(414) 425-8267
Mailing address
7400 W RAWSON AVE, SUITE 225, FRANKLIN, WI 53132-8278
(414) 425-8232
(414) 425-8267
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2467-023
WI
363AS0400X
Surgical Physician Assistant
2467-023
WI
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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