Individual
SHAHRIAR ALIZADEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
9200 W WISCONSIN AVE, VASCULAR SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-8620
(414) 454-0152
Mailing address
9200 W WISCONSIN AVE, VASCULAR SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-8620
(414) 454-0152
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
62270
WI
2086S0129X
Vascular Surgery Physician
Primary
62270
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063647857
—
WI
Enumeration date
05/21/2009
Last updated
01/20/2021
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