Individual
ACHUTHAN SOURIANARAYANANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF GASTROENTEROLOGY, MILWAUKEE, WI 53226-3522
(414) 955-6830
(414) 955-6214
Mailing address
9200 W WISCONSIN AVE, DIVISION OF GASTROENTEROLOGY, MILWAUKEE, WI 53226-3522
(414) 955-6830
(414) 955-6214
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
35088998
OH
207RG0100X
Gastroenterology Physician
46701
KY
207RG0100X
Gastroenterology Physician
Primary
65061
WI
207RT0003X
Transplant Hepatology Physician
65061
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2744838
—
OH
Enumeration date
05/23/2007
Last updated
02/05/2016
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