Individual
BEKZOD SHODY ESHTEMIROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-0350
(414) 955-0094
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-0350
(414) 955-0094
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
746723
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083347603
—
WI
Enumeration date
07/01/2022
Last updated
08/31/2023
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