Pisang LLC

NPI #1316302797 in Prairie Du Chien, Wisconsin

Provider Information

NPI Number: 1316302797
Entity Type: Organization
Organization Name: Pisang LLC
Primary Specialty: Internal Medicine
Enumeration Date: Dec 29, 2015
Last Updated: Dec 29, 2015

Practice Location

Address: 37868 US HIGHWAY 18
City: Prairie Du Chien
State: Wisconsin
ZIP Code: 53821-8416
Phone: (702) 453-3799

Authorized Official

Name: BENNY KUSUMA, M.D.
Title: SOLE OWNER
Phone: (316) 209-1424

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary
Hospitalist	208M00000X

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