Individual
ASHA THALIATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2338
(414) 385-8987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.064402
IL
207R00000X
Internal Medicine Physician
67796
WI
208M00000X
Hospitalist Physician
Primary
67796
WI
Other
Enumeration date
05/26/2014
Last updated
11/29/2021
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