IndividualActive
Susiani Intan, MD
NPI 1114274529 · Neuro-ophthalmology Physician · Milwaukee, WI
Provider details
- NPI number
- 1114274529
- Entity type
- Individual
- Primary specialty
- Neuro-ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 62449 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone: (414) 385-1922
Fax: (414) 385-1988
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 735044
Chicago, IL 60673-5044
Registry dates
- Enumerated
- 2012-08-06
- Last updated
- 2024-10-14
- Certified
- 2024-10-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.