Individual
RAVINDRA HANUMAIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
48283-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34826200
—
WI
01
—
48283
WI STATE LICENSE
WI
Enumeration date
05/27/2006
Last updated
04/22/2024
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