Provider Demographics
NPI:1427314749
Name:NANDA, USHA (MD)
Entity type:Individual
Prefix:DR
First Name:USHA
Middle Name:
Last Name:NANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 TOWN CRIER CT
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3017
Mailing Address - Country:US
Mailing Address - Phone:262-352-5383
Mailing Address - Fax:
Practice Address - Street 1:3255 TOWN CRIER CT
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-3017
Practice Address - Country:US
Practice Address - Phone:262-352-5383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22861-20208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation