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Individual

DR. LARA RENEE INDIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8700
(414) 259-1522
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8700
(414) 259-1522

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
66231
WI
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
66231
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821484361
WI
Enumeration date
04/11/2015
Last updated
05/26/2021
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