Individual
DR. MAHTAB K SIDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5000 W CHAMBERS ST, SUITE N240A, MILWAUKEE, WI 53210-1650
(414) 874-4763
(414) 874-4160
Mailing address
6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
(414) 423-4100
(414) 423-4134
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
45476-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34373900
—
WI
Enumeration date
01/19/2006
Last updated
07/08/2007
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