Healthcare Provider Details

I. General information

NPI: 1306527403
Provider Name (Legal Business Name): SAAK AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18200 W CAPITOL DR STE 100
BROOKFIELD WI
53045-1445
US

IV. Provider business mailing address

18200 W CAPITOL DR
BROOKFIELD WI
53045-1445
US

V. Phone/Fax

Practice location:
  • Phone: 262-444-5149
  • Fax: 262-444-5459
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAMAGOPAL TUMULURI
Title or Position: MD, OWNER
Credential: MD
Phone: 414-649-3530