Healthcare Provider Details

I. General information

NPI: 1235156563
Provider Name (Legal Business Name): ROOPA M. BHUPATHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROOPA M. KARRI M.D.

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 S MOORLAND RD 3RD FLOOR
NEW BERLIN WI
53151-7494
US

IV. Provider business mailing address

9000 W WISCONSIN AVE MS 958
MILWAUKEE WI
53226-4874
US

V. Phone/Fax

Practice location:
  • Phone: 262-432-7599
  • Fax: 262-432-7694
Mailing address:
  • Phone: 414-266-7615
  • Fax: 414-266-6238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number40343
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: