Provider Demographics
NPI:1811302375
Name:BASKARAN, ARTHY (MD)
Entity type:Individual
Prefix:
First Name:ARTHY
Middle Name:
Last Name:BASKARAN
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:N57W24950 N CORPORATE CIR
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-4383
Mailing Address - Country:US
Mailing Address - Phone:262-820-3093
Mailing Address - Fax:
Practice Address - Street 1:N57W24950 N CORPORATE CIR
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-4383
Practice Address - Country:US
Practice Address - Phone:262-820-3093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-09910207Q00000X
WI67314207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine