Individual
TALAL R KHAIRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5650 N GREEN BAY AVE STE 210, GLENDALE, WI 53209-4447
(414) 431-5971
(414) 434-0354
Mailing address
5650 N GREEN BAY AVE STE 210, GLENDALE, WI 53209-4447
(414) 431-5971
(414) 434-0354
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
64355
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10045943
—
WI
Enumeration date
06/19/2008
Last updated
12/17/2021
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