Individual
DR. MASSIHULLAH HAMIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2000 E LAYTON AVE, ST FRANCIS, WI 53235-6053
(414) 744-6589
(414) 747-8848
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036137524
IL
2085R0202X
Diagnostic Radiology Physician
Primary
67127
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100067597
—
WI
05
—
1043509680
—
WI
01
—
K400392067
MEDICARE
WI
Enumeration date
04/05/2011
Last updated
10/13/2023
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