Doctor Name: | INDIRA MAMMEN |
NPI Number: | 1427094796 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 21773 |
Business Practice Address: | 4922 Columbia Rd Cedarburg, WI - 530129188 |
Business Phone Number: | 2623752829 |
Business Fax Number: | 2623758513 |
Mailing Address: | 4922 Columbia Rd, CEDARBURG |
State: | WI |
Postal Code: | 530129188 |
Phone Number: | 2623752829 |
Fax Number: | 2623758513 |
NPI Enumeration Date: | 06/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 21773 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |