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: WI  62449)
Enumeration Date2012-08-06
Last Update Date2024-10-14
Business Address
SUSIANI INTAN MD
2801 W KINNICKINNIC RIVER PKWY
MILWAUKEE, WI 53215-3669
Phone number: 414-385-1922
Mailing Address
SUSIANI INTAN MD
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 800-326-2250