Provider Demographics
NPI:1902979750
Name:KOUNEV, VENELIN (MD)
Entity Type:Individual
Prefix:DR
First Name:VENELIN
Middle Name:
Last Name:KOUNEV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 N JEFFERSON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3710
Mailing Address - Country:US
Mailing Address - Phone:414-226-4025
Mailing Address - Fax:414-274-6250
Practice Address - Street 1:3501 E RAMSEY AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-3009
Practice Address - Country:US
Practice Address - Phone:414-647-7170
Practice Address - Fax:414-662-2507
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI45541207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1902979750Medicaid
WI108073601Medicare PIN
WI680860608Medicare PIN