Healthcare Provider Details

I. General information

NPI: 1730839184
Provider Name (Legal Business Name): BORAN KATUNARIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W. WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W. WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-8700
  • Fax: 414-805-6147
Mailing address:
  • Phone: 414-805-8700
  • Fax: 414-805-6147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number1026224
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: