Organization
MALA THENAPPAN, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALA THENAPPAN MD (PRESIDENT)
(414) 875-9950
Entity
Organization
Contact information
Practice address
3070 N 51ST ST, SUITE 100, MILWAUKEE, WI 53210-1645
(414) 875-9950
(414) 447-2575
Mailing address
3070 N 51ST ST, SUITE 100, MILWAUKEE, WI 53210-1645
(414) 875-9950
(414) 447-2575
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32430500
—
WI
Enumeration date
05/23/2006
Last updated
08/22/2020
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