Ram K Mittal MD SC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20701 Issued in WI

Legal business name

RAM K MITTAL MD SC

Practice address

902 Milwaukee Ave
South Milwaukee, WI 53172-2118

Phone

(414) 762-3910

Fax

(414) 762-9694

NPI assigned

Dec 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ram K Mittal, MD

Title

Owner

Phone

(414) 762-3910

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1831371442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 MILWAUKEE AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722118",
            "telephone_number": "414-762-3910",
            "fax_number": "414-762-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 MILWAUKEE AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722118",
            "telephone_number": "414-762-3910",
            "fax_number": "414-762-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAM K MITTAL MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "MITTAL",
        "authorized_official_first_name": "RAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-762-3910",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": "20701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30152400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "020020620",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Care of Wisconsin, LLC. (CMS South Milwaukee)
• Premier Care of Wisconsin, LLC. (Community Medical Services- South Milwaukee)
• Premise Health of Connecticut Medical, P.C.
• Madeline Preston, OTD
• R&D Care Journey LLC
• Samantha Marie Ramirez, COTA
• Christina Caroline Ramos, LPC, CSAC
• Katie J Rasmussen, PA-C
• Tammy Lynn Reid, PT
• Amanda Rensch, SLP

• Surgery Physician in South Milwaukee, WI
• Providers in South Milwaukee, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.