Individual
SANKALP DWIVEDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 738-2000
Mailing address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 738-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
71749
WI
207RG0100X
Gastroenterology Physician
Primary
71749
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099717
—
WI
Enumeration date
08/06/2014
Last updated
03/21/2025
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