Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 1367 | WI |
N | 2080P0201X | Pediatric Allergist | 50618-20 | WI |
NPI | 1568413839 |
---|---|
Provider Name | Sujani Kakumanu |
First Address | Madison, WI 53792-0001 |
Second Address | Madison, WI 53792-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 27/01/2021 |