Provider Demographics
NPI:1568534824
Name:RAMANUJAM, SRIHARI R (MD)
Entity Type:Individual
Prefix:DR
First Name:SRIHARI
Middle Name:R
Last Name:RAMANUJAM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:788 N. JEFFERSON STREET
Mailing Address - Street 2:SUITE 300/ATTN. KAAREN BUTZEN
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202
Mailing Address - Country:US
Mailing Address - Phone:414-272-8950
Mailing Address - Fax:414-272-0859
Practice Address - Street 1:13133 N. PORT WASHINGTON ROAD
Practice Address - Street 2:SUITE G-16
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53097
Practice Address - Country:US
Practice Address - Phone:262-243-2500
Practice Address - Fax:262-243-5395
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2016-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI46824207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1568534824Medicaid
WI003273645Medicare PIN
WI001846210Medicare PIN