Individual
HUMERA FATIMA AHMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700
Mailing address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
64385-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2014
Last updated
07/09/2019
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