Provider Demographics
NPI:1588034227
Name:KARANAM, SRIKAR (DO)
Entity type:Individual
Prefix:
First Name:SRIKAR
Middle Name:
Last Name:KARANAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 E GREEN TREE CT APT C
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-2278
Mailing Address - Country:US
Mailing Address - Phone:513-373-9556
Mailing Address - Fax:
Practice Address - Street 1:161 S RIVERHEATH WAY STE 2600
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915
Practice Address - Country:US
Practice Address - Phone:513-373-9556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.007148207P00000X
WI75272207P00000X
MS25252207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine