Organization
AFTAB A ANSARI, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AFTAB A ANSARI M.D., S.C. (OWNER)
(262) 652-4878
Entity
Organization
Contact information
Practice address
3535 30TH AVE, SUITE 101B, KENOSHA, WI 53144-1632
(262) 652-4878
Mailing address
3535 30TH AVE, SUITE 101B, KENOSHA, WI 53144-1632
(262) 652-4878
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
21598
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30186800
—
WI
Enumeration date
12/12/2007
Last updated
04/20/2008
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