Individual
FERIDOUN BEROUKHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2424 S 90TH ST, STE 504, WEST ALLIS, WI 53227-2455
(414) 328-8670
Mailing address
2448 S 102ND ST, STE 125, WEST ALLIS, WI 53227-2466
(414) 328-3809
(414) 328-3818
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18648
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30922300
—
WI
Enumeration date
07/17/2006
Last updated
07/08/2007
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