Individual
SUDEEP S SODHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8100
Mailing address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8100
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
42404
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33333400
—
WI
Enumeration date
09/06/2005
Last updated
12/11/2020
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