| Kaushalya Beniwal M D S C | |
|
2745 W Layton Ave Suite 104 Milwaukee WI 53221-2651 | |
| (414) 282-1961 | |
| Not Available |
| Full Name | Kaushalya Beniwal M D S C |
|---|---|
| Speciality | Family Medicine |
| Location | 2745 W Layton Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Kaushalya Beniwal (PRESIDENT) |
| Authorized Official Contact | 4142821961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaushalya Beniwal M D S C 2745 W Layton Ave Suite 104 Milwaukee WI 53221-2651 Ph: (414) 282-1961 | Kaushalya Beniwal M D S C 2745 W Layton Ave Suite 104 Milwaukee WI 53221-2651 Ph: (414) 282-1961 |
| NPI Number | 1447580881 |
|---|---|
| Provider Enumeration Date | 01/07/2010 |
| Last Update Date | 04/21/2011 |
| Medicare PECOS PAC ID | 6800923822 |
|---|---|
| Medicare Enrollment ID | O20100423000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447580881 | NPI | - | NPPES |
| 30621400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25201 (Wisconsin) | Primary |
| Provider Name | Kaushalya Beniwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760408058 PECOS PAC ID: 7719014646 Enrollment ID: I20100423000443 |
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