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Organization

ADVANCED EAR NOSE & THROAT SPECIALISTS, SC

Active
Other names
ADVENT
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MADAN N KANDULA MD (CEO)
(888) 938-3838
Entity
Organization

Contact information

Practice address
2885 N MAYFAIR RD, MILWAUKEE, WI 53222-4404
(888) 889-3838
Mailing address
10001 W INNOVATION DR STE 200, WAUWATOSA, WI 53226-4851
(888) 938-3838
(888) 919-1083

Taxonomy

Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
44930 020
WI
231H00000X
Audiologist
434 156
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34336200
WI
Enumeration date
08/29/2006
Last updated
10/26/2021
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