Individual
DR. KRISADA CHANBUSARAKUM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 S PARK ST, MADISON, WI 53715-1348
(608) 255-4223
(608) 255-4449
Mailing address
5005 COTTAGE GROVE RD, MADISON, WI 53716-1309
(608) 221-8999
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
20690
WI
Other
Enumeration date
03/28/2006
Last updated
07/08/2007
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