Provider Demographics
NPI:1497700637
Name:KRISHNANEY, ASHOK R (MD)
Entity Type:Individual
Prefix:
First Name:ASHOK
Middle Name:R
Last Name:KRISHNANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4555 WEST SCHROEDER DRIVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223
Mailing Address - Country:US
Mailing Address - Phone:414-365-3210
Mailing Address - Fax:414-365-3225
Practice Address - Street 1:3237 SOUTH 16TH STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4592
Practice Address - Country:US
Practice Address - Phone:414-647-5771
Practice Address - Fax:414-647-7134
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI19234207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30896200Medicaid
WIB85613Medicare UPIN
WI30896200Medicaid