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Individual

DR. MANOJ RAGHAVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9200 W WISCONSIN AVE, DEPT OF NEUROLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5200
(414) 259-0469
Mailing address
9200 W WISCONSIN AVE, DEPT OF NEUROLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5200
(414) 259-0469

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
45746
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006806261X
HUMANA
05
1467404178
WI
Enumeration date
05/17/2006
Last updated
03/31/2014
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