Individual
GANESH KUMAR NAMACHIVAYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
733 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6101
(715) 838-5222
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
24286
NE
208000000X
Pediatrics Physician
Primary
50153-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902098486
—
WI
Enumeration date
08/17/2007
Last updated
08/09/2022
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