Provider Demographics
NPI:1376619957
Name:TUMMALA, ARUNA K (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUNA
Middle Name:K
Last Name:TUMMALA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:19385 BUCKINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-6200
Mailing Address - Country:US
Mailing Address - Phone:262-955-6601
Mailing Address - Fax:262-955-6607
Practice Address - Street 1:12800 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-4062
Practice Address - Country:US
Practice Address - Phone:262-955-6601
Practice Address - Fax:262-955-6607
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2017-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI49817-020208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WII71099Medicare UPIN