Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 42792 | WI |
NPI | 1205804010 |
---|---|
Provider Name | Mrs. Shardha Srinivasan |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 12/01/2021 |