Jazayeri, Mohammad R
Jazayeri, Mohammad R is an individual health care provider with primary practice located at 744 S Webster Ave 2Nd Floor, Green Bay WI 54301-3505. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Jazayeri, Mohammad R can be contacted via phone (920) 433-3640.Contact Information
Primary practice address
744 S Webster Ave 2Nd Floor
Green Bay WI 54301-3505
Phone: (920) 433-3640
Fax: (920) 433-3716
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 27239 | Wisconsin |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 27239-20 | Wisconsin |
Profile Details
| NPI number | 1336238161 |
|---|---|
| LBN Legal business name | Jazayeri, Mohammad R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Nov 28th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336238161 | NPPES |
| Wisconsin | MEDICAID | 30770600 |
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