Organization
RAM K MITTAL MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAM K MITTAL MD (OWNER)
(414) 762-3910
Entity
Organization
Contact information
Practice address
902 MILWAUKEE AVE, SOUTH MILWAUKEE, WI 53172-2118
(414) 762-3910
(414) 762-9694
Mailing address
902 MILWAUKEE AVE, SOUTH MILWAUKEE, WI 53172-2118
(414) 762-3910
(414) 762-9694
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20701
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020020620
RR MEDICARE
—
05
—
30152400
—
WI
Enumeration date
12/05/2007
Last updated
03/15/2012
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