Mirza, Shazia

Mirza, Shazia is an individual health care provider with primary practice located at 1020 35Th St , Kenosha WI 53140-1902. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Mirza, Shazia can be contacted via phone (262) 652-3500.

Contact Information

Primary practice address
1020 35Th St Kenosha WI 53140-1902
Phone: (262) 652-3500
Fax: (262) 925-8353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-115477 Illinois

Profile Details

NPI number 1972547040
LBN Legal business name Mirza, Shazia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Apr 25th, 2008 - about 16 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 1972547040 NPPES
Wisconsin Other 83832 DEAN S.E. MEDICAID
Wisconsin Other 1069731001 DEAN S.E. MEDICAID
Wisconsin Other 83832 DEAN S.E. MEDICAID
Wisconsin MEDICAID 34738600 DEAN S.E. MEDICAID
Wisconsin Other 0622304 DEAN S.E. MEDICAID

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