Ponthenkandath, Sasidharan
Ponthenkandath, Sasidharan is an individual health care provider with primary practice located at 9000 W Wisconsin Ave , Milwaukee WI 53226-3518. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Ponthenkandath, Sasidharan can be contacted via phone (414) 805-3666.Contact Information
Primary practice address
9000 W Wisconsin Ave
Milwaukee WI 53226-3518
Phone: (414) 805-3666
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 28183 | Wisconsin |
Profile Details
| NPI number | 1215132790 |
|---|---|
| LBN Legal business name | Ponthenkandath, Sasidharan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2007 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215132790 | NPPES |
| Other | 137-405-7 | ECFMG | |
| MEDICAID | 30783600 | ECFMG | |
| Other | 559798 | ECFMG |
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