Individual
SARVADAMAN JEET KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 SMITH AVE, OCONTO, WI 54153-1080
(920) 496-4700
Mailing address
620 SMITH AVE, OCONTO, WI 54153-1080
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39805
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32469200
—
WI
Enumeration date
07/14/2006
Last updated
03/05/2013
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