Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 18391-875 | WI |
NPI | 1669558433 |
---|---|
Provider Name | Dr. Yeshwant B Rawal |
First Address | Milwaukee, WI 53233-2186 |
Second Address | Milwaukee, WI 53233-2186 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 17/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18391-875 | THE STATE OF WISCONSIN, DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES (01) | WI |