# AFTAB A ANSARI, M.D., S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104009240
- **Authorized official:** DR. AFTAB A ANSARI M.D., S.C. (OWNER)
- **Authorized official phone:** (262) 652-4878

## Contact information

- **Practice address:** 3535 30TH AVE, SUITE 101B, KENOSHA, WI 53144-1632
- **Practice address phone:** (262) 652-4878
- **Mailing address:** 3535 30TH AVE, SUITE 101B, KENOSHA, WI 53144-1632
- **Mailing address phone:** (262) 652-4878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207XS0106X | Orthopaedic Hand Surgery Physician | 21598 | WI | Yes |

## Other

- **Enumeration date:** 12/12/2007
- **Last updated:** 04/20/2008