Individual
SRINANDAN GUNTUPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
1580 COMMANCHE AVE, GREEN BAY, WI 54313-5751
(920) 435-8326
(920) 430-4659
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
74565
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538543780
AMERICAN BOARD OF INTERNAL MEDICINE
—
Enumeration date
07/17/2015
Last updated
07/07/2021
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