Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 54086 | WI |
N | 111NI0900X | Internist | 54086 | WI |
N | 207RH0000X | Hematologist | 54086 | WI |
Y | 207RX0202X | Medical Oncology | 54086 | WI |
NPI | 1265609564 |
---|---|
Provider Name | Sumana Devata |
First Address | Milwaukee, WI 53226-3522 |
Second Address | Milwaukee, WI 53226-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 26/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1265609564 | (05) | WI |