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General NPI Number Information
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NPI Number | 1770720765
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Entity Type | Organization
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Legal Business Name | TOSA MEDICAL GROUP LLC
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 12/07/2012
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Provider Practice Location Address
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Address Line | 830 N 109TH ST SUITE 1
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City | WAUWATOSA
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State | WI
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Zip | 53226-3754
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Country | US
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Telephone | 414-777-1811
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Fax |
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Provider Business Mailing Address
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Address Line | 830 N 109TH ST SUITE 1
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City | WAUWATOSA
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State | WI
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Zip | 53226-3754
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Country | US
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Telephone | 414-777-1811
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANILKUMAR DONIPARTHI
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Credential | M.D.
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Telephone | 414-777-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 38316
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License Number State | WI
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