Islam, Rezwan

Islam, Rezwan is an individual health care provider with primary practice located at 3501 Cranberry Blvd , Weston WI 54476. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Islam, Rezwan can be contacted via phone (715) 847-3017.

Contact Information

Primary practice address
3501 Cranberry Blvd Weston WI 54476
Phone: (715) 847-3017
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 41049 Wisconsin
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 41049 Wisconsin

Profile Details

NPI number 1154417145
LBN Legal business name Islam, Rezwan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154417145 NPPES
Wisconsin MEDICAID 32548600

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