Individual
DR. MANISH J GHARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13800 W NORTH AVE STE 100, BROOKFIELD, WI 53005-4977
(262) 754-4940
(262) 754-4940
Mailing address
765 SAFER CT, BROOKFIELD, WI 53045-6783
(414) 313-0255
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
39577
WI
207ND0101X
MOHS-Micrographic Surgery Physician
39577
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376565267
—
WI
Enumeration date
07/23/2006
Last updated
10/01/2024
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