Search › Wisconsin › 207RP1001X
Jason Prudom, M.D
NPI 1265775993 · on the registry since 2013
Practice
- Address
- 3201 S 16th St Ste 2015
Milwaukee, WI 53215 - Phone
- (414) 649-3810
- Fax
- (262) 240-0841
- Organisation at this address
- St. Francis Graphics
St Francs Pediatrics
Farzad Kamrani,Md.Sc.
Southwest Pharmacy Inc
Jitendra K Baruah Md ScInferred from a shared address, not stated in the registry. - Clinicians at this address
- 27
Registry record
- Primary taxonomy
- 207RP1001X
207RP1001X
- Also registered as
- 207RC0200X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-03-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin