Basic Information
| Provider Information | |||||||||
| NPI: | 1568418937 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SRIVASTAVA | ||||||||
| FirstName: | ALOK | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 580 N WASHINGTON ST | ||||||||
| Address2: | DEAN MEDICAL CENTER | ||||||||
| City: | JANESVILLE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535482908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6087553500 | ||||||||
| FaxNumber: | 6087553792 | ||||||||
| Practice Location | |||||||||
| Address1: | 580 N WASHINGTON ST | ||||||||
| Address2: | DEAN MEDICAL CENTER | ||||||||
| City: | JANESVILLE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535482908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6087553500 | ||||||||
| FaxNumber: | 6087553792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 07/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 38127-020 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.