Individual
DR. SATYA KISHORE GUTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8701 W WATERTOWN PLANK RD, MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS PROGR, MILWAUKEE, WI 53226-3548
(414) 955-8998
(414) 955-6299
Mailing address
4656 W JEFFERSON BLVD STE 201, FORT WAYNE, IN 46804-6857
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
01086475A
IN
2084P0800X
Psychiatry Physician
Primary
01086475A
IN
2084P0805X
Geriatric Psychiatry Physician
61391
WI
208D00000X
General Practice Physician
60291
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2012
Last updated
02/18/2022
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