Individual
PRASUN PUDASAINEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-0350
(414) 955-0094
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-0350
(414) 955-0094
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
83043
WI
208M00000X
Hospitalist Physician
Primary
83043
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700550738
—
WI
Enumeration date
08/03/2021
Last updated
06/19/2024
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