Individual
KALI MANIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 793-2281
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.074674
IL
207RI0200X
Infectious Disease Physician
036.160005
IL
207RI0200X
Infectious Disease Physician
Primary
84158
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100281307
—
WI
Enumeration date
06/20/2019
Last updated
11/04/2024
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