Individual
LEONAS PRANAS SULAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2817 NEW PINERY ROAD, DIVINE SAVIOR HEALTHCARE, PORTAGE, WI 53901-0387
(608) 745-5603
(608) 742-6098
Mailing address
2817 NEW PINERY ROAD, PO BOX 387, DIVINE SAVIOR HEALTHCARE, PORTAGE, WI 53901-0387
(608) 745-5603
(608) 742-6098
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
27361020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30689000
—
WI
01
—
60643
DEAN HEALTH INSURANCE
WI
Enumeration date
06/06/2006
Last updated
11/29/2007
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