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Individual

DR. RIYAZUDDIN S MOGALAI

Active
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Individual

DR. RIYAZUDDIN S MOGALAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
63783
WI
208M00000X
Hospitalist Physician
Primary
63783
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000628125
ANTHEM PROVIDER NUMBER
IN
01
—
000000748342
ANTHEM
IN
05
—
0060603
—
OH
05
—
200972310
—
IN
01
—
P01040162
RR MEDICARE
IN
Enumeration date
08/18/2008
Last updated
11/19/2020
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