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Organization

ADVANCED EAR NOSE & THROAT SPECIALISTS, SC

Active
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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
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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