Individual
BHARATHI PULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
6125 GREEN BAY RD, KENOSHA, WI 53142-2928
(262) 564-8636
(262) 564-8637
Mailing address
6125 GREEN BAY RD, KENOSHA, WI 53142-2928
(262) 564-8636
(262) 564-8637
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
41182
WI
207QG0300X
Geriatric Medicine (Family Medicine) Physician
41182
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34105600
—
WI
Enumeration date
01/05/2007
Last updated
06/28/2023
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