Individual
VIJAY K KANTAMNENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 S PARK ST, DEAN & ST. MARY'S OUTPATIENT CENTER, MADISON, WI 53715-1830
(608) 260-2900
Mailing address
700 S PARK ST, DEAN & ST. MARY'S OUTPATIENT CENTER, MADISON, WI 53715-1830
(608) 260-2900
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
28003-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31497100
—
WI
01
—
3564
DEAN HEALTH INSURANCE
WI
01
—
770000422
RAILROAD MEDICARE
WI
Enumeration date
05/11/2006
Last updated
12/28/2023
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