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Susiani Intan, MD
Neuro-ophthalmology Physician in Milwaukee, Wisconsin
NPI 1114274529

Susiani Intan is a Neuro-ophthalmology Physician based in Chicago, WI and is specialized in Neuro-ophthalmology. Susiani Intan practices in Milwaukee, WI and has the professional credentials of MD. The NPI Number for Susiani Intan is 1114274529 and holds a License No. 62449 (Wisconsin).

The current practice location address for Susiani Intan is 2801 W Kinnickinnic River Pkwy, Milwaukee, WI and can be reached out via phone at 414-385-1922 and via fax at 414-385-1988.

Location: 2801 W Kinnickinnic River Pkwy, Milwaukee, WI, 60673-5044
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114274529
Provider Name
Susiani Intan
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
2801 W Kinnickinnic River Pkwy, Milwaukee, WI, 60673-5044
Phone Number
414-385-1922
Fax Number
414-385-1988
Provider Enumeration Date
08/06/2012
Last Update Date
11/16/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100038273 05 WI
1114274529 05 WA
G8966407 01 WA WVH PTAN
G8966408 01 WA WVH PTAN
institution
Provider Business Practice Location Address Details
Address
2801 W Kinnickinnic River Pkwy
City
Milwaukee
State
Wisconsin
Zip
53215-3669
Phone Number
414-385-1922
Fax Number
414-385-1988
person
Provider Business Mailing Address Details
Address
2801 W Kinnickinnic River Pkwy
City
Milwaukee
State
Wisconsin
Zip
53215-3669
Phone Number
414-385-1922
Fax Number
414-385-1988
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Ophthalmology
Speciality
Neuro-ophthalmology
Taxonomy
207WX0109X
License No.
62499 (Wisconsin)
Definition
A neuro-ophthalmologist is a subspecialist of ophthalmology. This physician evaluates, treats, and studies disorders of the eye, orbit and nervous system having to do with interactions of the visual motor and visual sensory systems with the central nervous system. Neuro-ophthalmologists manage patients with complex and severe neuro-ophthalmological disorders.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
2084N0400X
License No.
62449 (Wisconsin)
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
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