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NPI Code Detail

MEDICARE: DR. DEBESH CHANDRA MAZUMDAR M.D.

MEDICARE: DR. DEBESH CHANDRA MAZUMDAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician22721-020WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427032960
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBESH CHANDRA MAZUMDAR M.D.
Provider Business Mailing Address
First Line : 1575 N RIVERCENTER DR
Second Line : SUITE 104
City : MILWAUKEE
State : WI
Zip : 53212-3978
Country : US
Telephone Number : 414-274-7520
Fax Number : 414-274-7525
Provider Business Practice Location Address
First Line : 1575 N RIVERCENTER DR
Second Line : SUITE 104
City : MILWAUKEE
State : WI
Zip : 53212-3978
Country : US
Telephone Number : 414-274-7520
Fax Number : 414-274-7525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 07/08/2007

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