Individual
ANNA L GANJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 649-3240
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2536
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659609592
—
WI
05
—
736011584
—
WI
Enumeration date
12/04/2009
Last updated
12/04/2024
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