Sujan Fernando (NPI# 1023272200, PAC ID# 6103066709) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1023272200 |
| PAC ID by PECOS | 6103066709 |
| Professional Enrollment ID | I20140717002543 |
| Full Name | Sujan Fernando |
| Organization Legal Name | THE MEDICAL COLLEGE OF WISCONSIN INC |
| Address |
21700 Intertech Dr Brookfield WI 53045-5197 |
| Phone Number | 2625328300 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Secondary Specialties | INTERVENTIONAL RADIOLOGY |
| Group Practice PAC ID | 2668384371 |
| Number of Group Practice Members | 1573 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520177 | FROEDTERT MEMORIAL LUTHERAN HOSPITAL |
| 520063 | ST JOSEPHS COMMUNITY HOSPITAL WEST BEND |
| 520103 | COMMUNITY MEMORIAL HOSPITAL |
| 520051 | COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE |
| 520021 | UNITED HOSPITAL SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 1350 S Sunny Slope Rd, Brookfield, WI 53005-7060 | 4148059600 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| 1905 N Calhoun Rd, Brookfield, WI 53005-5036 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN | |
| 21700 Intertech Dr, Brookfield, WI 53045-5197 | 2625328300 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| W168n11237 Western Ave, Germantown, WI 53022-3239 | 2622535060 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| 110 Lone Oak Ln, Hartford, WI 53027-2600 | 2626701800 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| W225n16711 Cedar Park Ct, Jackson, WI 53037-9222 | 2626771101 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| 1701 Fond Du Lac Ave, Kewaskum, WI 53040-9129 | 2626264616 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| N91w15750 Falls Pkwy, Menomonee Falls, WI 53051-2301 | 2625321100 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| W180n8000 Town Hall Rd, Menomonee Falls, WI 53051-4002 | 2622552500 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| W180n8045 Town Hall Rd, Menomonee Falls, WI 53051-3518 | THE MEDICAL COLLEGE OF WISCONSIN INC | |
| W180n8085 Town Hall Rd, Suite 301, Menomonee Falls, WI 53051-3518 | 2622573220 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| 1155 N Mayfair Rd B, Milwaukee, WI 53226-3462 | 4144567199 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| 1271 N 6th St, Milwaukee, WI 53212-3360 | 4149789100 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 4145278191 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| 8700 W Watertown Plank Rd, Milwaukee, WI 53226-3595 | 4148057100 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 4144564100 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 4148050505 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| 4805 S Moorland Rd, New Berlin, WI 53151-7401 | 2627987200 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| 2315 E Moreland Blvd, Waukesha, WI 53186-2939 | 2625325700 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| 1155 N Mayfair Rd, Wauwatosa, WI 53226-3462 | 4149555990 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2623343451 | FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS IN |
| 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | THE MEDICAL COLLEGE OF WISCONSIN INC |
| Organization Legal Name | THE MEDICAL COLLEGE OF WISCONSIN INC |
| Physicians | 1866 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Manders | Nurse Practitioner | The Medical College of Wisconsin Inc | 2400 W Villard Ave, Milwaukee, WI 53209-4901 |
| Sachin Shivaji Kumbhar | Diagnostic Radiology | The Medical College of Wisconsin Inc | 3195 Hillside Dr, Delafield, WI 53018-2189 |
| Karen E Kersting | Psychologist, Clinical | The Medical College of Wisconsin Inc | 1121 E N Ave, Milwaukee, WI 53212-3515 |
| Abdel Hai Alqwasmi | Hematology/oncology | The Medical College of Wisconsin Inc | W180n8045 Town Hall Rd, Menomonee Falls, WI 53051-3518 |
| Jacqueline K Dake | Nurse Practitioner | The Medical College of Wisconsin Inc | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 |
| Claire T Rich | Clinical Nurse Specialist | The Medical College of Wisconsin Inc | 1155 N Mayfair Rd B, Milwaukee, WI 53226-3462 |
| Piero G Antuono | Neurology | The Medical College of Wisconsin Inc | 1238 S Cesar E Chavez Dr, Milwaukee, WI 53204-2267 |
| John N Jensen | Plastic and Reconstructive Surgery | The Medical College of Wisconsin Inc | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 |
| Anne E B Lakatos | Nurse Practitioner | The Medical College of Wisconsin Inc | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 |
| Karie N Zach | Sports Medicine | The Medical College of Wisconsin Inc | 8700 W Watertown Plank Rd, Wauwatosa, WI 53226-3595 |
| Street Address |
21700 INTERTECH DR |
| City | BROOKFIELD |
| State | WI |
| Zip | 53045-5197 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Stephen Symanski | Diagnostic Radiology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Stephane L Desouches | Diagnostic Radiology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Luis A Sosa Lozano | Diagnostic Radiology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Melissa M Wein | Diagnostic Radiology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Dhiraj Baruah | Diagnostic Radiology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Stephen J Johnston | Diagnostic Radiology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Rajeev R Mannem | Radiation Oncology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Scott J Erickson | Diagnostic Radiology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Michael L Cada | Pediatric Medicine | Froedtert and The Medical College of Wisconsin Community Physicians In | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Sean M Lehner | Diagnostic Radiology | The Medical College of Wisconsin Inc | 21700 Intertech Dr, Brookfield, WI 53045-5197 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth A Moberg Wolff | Physical Medicine and Rehabilitation | 3815 N Brookfield, Suite 264, Brookfield, WI 53045-1964 | |
| Michael Giammarco | Chiropractic | Goodyear Chiropractic Health Center. S.c. | 17495 W Capitol Dr L, Brookfield, WI 53045-2059 |
| Jeffrey T Follansbee | Anesthesiology | 17495 W Capitol Dr, Brookfield, WI 53045-2059 | |
| Robert D Matteucci | Podiatry | Great Midwest Foot and Ankle Centers, S.c. | 17495 W Capitol Dr, Suite L, Brookfield, WI 53045-2059 |
| Phillip E Roy | Optometry | 17495 W Capitol Dr, Suite D, Brookfield, WI 53045-2059 | |
| Zachary C Johnson | Physical Therapy | Sports Physical Therapy and Rehab Specialist Sc. | 17495 W Capitol Dr, Brookfield, WI 53045-2059 |
| Lynne E Zaborske Roy | Optometry | 17495 W Capitol Dr, Brookfield, WI 53045-2059 | |
| Jacqueline L Landers | Clinical Social Worker | 19275 W Capitol Dr, Suite 200, Brookfield, WI 53045-2734 | |
| Sonya S Trueblood | Psychologist, Clinical | 19275 W Capitol Dr, Suite 200, Brookfield, WI 53045-2734 | |
| Nicholas James Wilson | Chiropractic | 19265 W Capitol Dr B, Brookfield, WI 53045-2740 | |
| Find all physicians in zip 53045 | |||
| City | BROOKFIELD |
| Zip Code | 53045 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | BROOKFIELD + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Sujan Fernando.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.