Healthcare Provider Details

I. General information

NPI: 1982697215
Provider Name (Legal Business Name): TITILOLA OLADUNNI BRITTO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 07/21/2022
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W KINNICKINNIC RIVER PKWY STE 315
MILWAUKEE WI
53215-3660
US

IV. Provider business mailing address

2901 W KINNICKINNIC RIVER PKWY STE 315
MILWAUKEE WI
53215-3660
US

V. Phone/Fax

Practice location:
  • Phone: 414-385-2590
  • Fax:
Mailing address:
  • Phone: 414-385-2590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number045471
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number66388
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: