Benny Kusuma MD

NPI 1073734133 - Internal Medicine - 207R00000X

NPI Details
NPI 1073734133
Gender Male
Enumeration Date 05/02/2007
Last Updated 02/08/2016
Entity Type Individual
Active Over 9 years ago
Practice Location
1836 SOUTH AVE
LA CROSSE WI, 54601-5429, US
Phone (608) 782-7300
Fax
Business Location
1836 SOUTH AVE
LA CROSSE WI, 54601-5429, US
Phone (608) 782-7300
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Kansas
License Number 6295
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According to our database, Benny Kusuma MD NPI is 1073734133, taxonomy code is 207R00000X and license number is 6295, license state is located at Kansas. Benny Kusuma MD physically located at 1836 South Ave, La Crosse WI, 54601-5429. NPI Number Benny Kusuma MD has the Individual type.

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1073734133 NPI number is provided on an as is basis without warranty of any kind. 1073734133 is maintained by the National Plan & Provider Enumeration System. The contents of Benny Kusuma MD are for informational purposes only.