SUSIANI INTAN

MILWAUKEE, WI
NPI1114274529
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207WX0109X Ophthalmology, Neuro-ophthalmology
(Licence: WI  62499)
Additional Taxonomies2084N0400X Psychiatry & Neurology, Neurology
(Licence: WA  MD60712039)
2084N0400X Psychiatry & Neurology, Neurology
(Licence: CA  A168657)
207R00000X Internal Medicine
(Licence: WA  MD60712039)
2084N0400X Psychiatry & Neurology, Neurology
(Licence: WI  62449)
Enumeration Date2012-08-06
Last Update Date2024-09-17
Business Address
SUSIANI INTAN MD
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215-3669
Phone number: 414-385-1922
Mailing Address
SUSIANI INTAN MD
3301 W FOREST HOME AVE
MILWAUKEE, WI 53215-2843
Phone number: