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1578642856
CHANNAGATTA R TRIYAMBAKARAJ
MILWAUKEE, WI
NPI
1578642856
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: WI 19733)
Enumeration Date
2006-11-06
Last Update Date
2012-06-12
Business Address
-- CHANNAGATTA R TRIYAMBAKARAJ MD
2311 N PROSPECT AVE
MILWAUKEE, WI 53211-4445
Phone number: 414-319-3000
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Mailing Address
-- CHANNAGATTA R TRIYAMBAKARAJ MD
4425 N PORT WASHINGTON RD ATTN: CLINIC CREDENTIALING
GLENDALE, WI 53212-1082
Phone number: 414-319-3000
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