Khan, Ijaz Mohammad

Khan, Ijaz Mohammad is an sole proprietor health care provider with primary practice located at 6026 W Lisbon Ave , Milwaukee WI 53210-2114. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Khan, Ijaz Mohammad can be contacted via phone (414) 334-9715.

Contact Information

Primary practice address
6026 W Lisbon Ave Milwaukee WI 53210-2114
Phone: (414) 334-9715
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 34065-020 Wisconsin

Profile Details

NPI number 1952434011
LBN Legal business name Khan, Ijaz Mohammad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2007
Last updated Jul 8th, 2007 - about 19 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 1952434011 NPPES
Wisconsin MEDICAID 32151400

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