Individual
PIYUSH K. RAJURKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 W LAYTON AVE, SUITE 110, MILWAUKEE, WI 53221-5420
(414) 281-0963
(414) 294-4396
Mailing address
6020 S PACKARD AVE, CUDAHY, WI 53110-3028
(414) 294-4660
(414) 294-4396
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
44292-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800323
PRIMECARE
WI
01
—
180046200
RR MEDICARE
WI
05
—
34192700
—
WI
01
—
391484998
TAX ID
WI
01
—
391484998011
BC/CCARE
WI
Enumeration date
10/05/2005
Last updated
03/05/2019
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