Individual
GANESH N PULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
6125 GREEN BAY RD, 100, KENOSHA, WI 53142-2928
(262) 564-8636
(262) 564-8637
Mailing address
6125 GREEN BAY RD, 100, KENOSHA, WI 53142-2928
(262) 564-8636
(262) 564-8637
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
40695
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21279800
—
WI
Enumeration date
01/05/2007
Last updated
07/08/2007
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