Individual
DR. MADAN N KANDULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2885 N MAYFAIR RD, MILWAUKEE, WI 53222-4404
(414) 771-6780
(414) 238-2424
Mailing address
10001 W INNOVATION DR STE 200, WAUWATOSA, WI 53226-4851
(414) 771-6780
(414) 238-2424
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
44930-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-1759813
CORPORATION TAX ID
WI
05
—
34336200
—
WI
Enumeration date
10/12/2005
Last updated
04/06/2021
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