Individual
MYSORE S SHIVARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7400 W RAWSON AVE, #225, FRANKLIN, WI 53132-8278
(414) 425-8232
(414) 425-8267
Mailing address
7400 W RAWSON AVE, STE 243, FRANKLIN, WI 53132-8280
(414) 425-8232
(414) 425-8267
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
22232
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30256600
—
WI
Enumeration date
06/26/2006
Last updated
05/22/2019
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