Quddus, Jawaid
Quddus, Jawaid is an sole proprietor health care provider with primary practice located at 6123 Green Bay Road Suite 120, Kenosha WI 53142-2927. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Quddus, Jawaid can be contacted via phone (262) 764-4390.Contact Information
Primary practice address
6123 Green Bay Road Suite 120
Kenosha WI 53142-2927
Phone: (262) 764-4390
Fax: (262) 764-4396
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 45606-020 | Wisconsin |
Profile Details
| NPI number | 1386631661 |
|---|---|
| LBN Legal business name | Quddus, Jawaid |
| Credentials | MD, PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 3rd, 2005 |
| Last updated | Apr 1st, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386631661 | NPPES |
| Wisconsin | MEDICAID | 34414100 |
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