Most Relevant Information
Provider Data
| NPI Number: | 1003078494 |
| Provider Name: | ELENA V ROUKHADZE M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207ZP0102X |
| Specialty: | Pathology |
| License Number: | 51124-020 |
Most Important Dates
| Enumeration Date: | 06/27/2008 |
| Last Updated: | 06/27/2008 |
Provider Practice Location
5000 W NATIONAL AVE
MILWAUKEE
WI
532950001
Practice Location Phone/Fax
| Phone: | 4143842000 |
| Fax: | 4143894187 |
Provider Mailing Location
5000 W NATIONAL AVE
MILWAUKEE
WI
532950001
Provider Mailing Phone/Fax
| Phone: | 4143842000 |
| Fax: | 4143894187 |