Individual
DR. NAGENDRAM PAIDISETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3801 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(262) 687-4011
Mailing address
3801 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(262) 687-4011
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
036-114717
IL
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
33013-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-114717
—
IL
05
—
1770696338
—
WI
05
—
31818700
—
WI
Enumeration date
08/17/2006
Last updated
03/17/2018
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