Individual
SHIVANI GUNDAMRAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1100 LAKE VIEW DRIVE, WAUSAU, WI 54403
(715) 848-4600
Mailing address
1900 WESTWOOD DRIVE, SUITE 3100, WAUSAU, WI 54401-4106
(715) 870-0906
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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