Shivaram, Mysore S

Shivaram, Mysore S is an individual health care provider with primary practice located at 7400 W Rawson Ave #225, Franklin WI 53132-8278. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hand Surgery, which is considered as his primary health care specialty. Shivaram, Mysore S can be contacted via phone (414) 425-8232.

Contact Information

Primary practice address
7400 W Rawson Ave #225 Franklin WI 53132-8278
Fax: (414) 425-8267
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X 22232 Wisconsin

Profile Details

NPI number 1750318903
LBN Legal business name Shivaram, Mysore S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated May 22nd, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750318903 NPPES
Wisconsin MEDICAID 30256600

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