| Tosa Medical Group Llc | |
|
830 N 109th St Suite 1 Wauwatosa WI 53226-3754 | |
| (414) 777-1811 | |
| Not Available |
| Full Name | Tosa Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 830 N 109th St, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Anilkumar Doniparthi (PRESIDENT) |
| Authorized Official Contact | 4147771811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tosa Medical Group Llc 830 N 109th St Suite 1 Wauwatosa WI 53226-3754 Ph: (414) 777-1811 | Tosa Medical Group Llc 830 N 109th St Suite 1 Wauwatosa WI 53226-3754 Ph: (414) 777-1811 |
| NPI Number | 1770720765 |
|---|---|
| Provider Enumeration Date | 01/13/2009 |
| Last Update Date | 12/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770720765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 38316 (Wisconsin) | Primary |
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