Provider Demographics
NPI:1992993232
Name:MASKI & MASKI MD
Entity type:Organization
Organization Name:MASKI & MASKI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RAVIKANT
Authorized Official - Middle Name:
Authorized Official - Last Name:MASKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-348-4677
Mailing Address - Street 1:1250 E BUS HWY 151
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLATTEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53818-3875
Mailing Address - Country:US
Mailing Address - Phone:608-348-4677
Mailing Address - Fax:608-348-7774
Practice Address - Street 1:1250 E BUS HWY 151
Practice Address - Street 2:SUITE A
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-3875
Practice Address - Country:US
Practice Address - Phone:608-348-4677
Practice Address - Fax:608-348-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23470207Q00000X, 208000000X
WI23145-020207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B54861Medicare UPIN
B85063Medicare UPIN
000124105Medicare PIN
000224105Medicare PIN