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Individual

DR. HARSHA VARDHAN POOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
1726 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 498-4200
Mailing address
1726 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 498-4200

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125059158
IL
207RH0003X
Hematology & Oncology Physician
Primary
66893
WI
207RH0003X
Hematology & Oncology Physician
Primary
66893-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100065279
WI
Enumeration date
08/02/2011
Last updated
03/19/2026
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