Organization
MYSORE SHIVARAM, MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYSORE S SHIVARAM M.D. (PROPRIETOR)
(414) 425-8232
Entity
Organization
Contact information
Practice address
7400 W RAWSON AVE, SUITE 225, FRANKLIN, WI 53132-8278
(414) 425-8232
Mailing address
7400 W RAWSON AVE, SUITE 225, FRANKLIN, WI 53132-8278
(414) 425-8232
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22232
WI
Other
Enumeration date
01/16/2008
Last updated
01/14/2013
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