Individual
JAYA PRAKASH BUDDINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, SUITE 315, MILWAUKEE, WI 53215-3677
(347) 387-3555
Mailing address
2901 W KINNICKINNIC RIVER PKWY, SUITE 315, MILWAUKEE, WI 53215-3677
(347) 387-3555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2009010646
MO
207R00000X
Internal Medicine Physician
MD443321
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
61965
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
61965-20
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD2021-0858
NM
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
P9053
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100038329
—
WI
Enumeration date
07/11/2007
Last updated
09/18/2023
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