Individual
MOADH MASOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6729 PIMA DR APT 202, MADISON, WI 53719-5669
(414) 840-4393
Mailing address
6729 PIMA DR APT 202, MADISON, WI 53719-5669
(414) 840-4393
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16755-40
WI
Other
Enumeration date
10/21/2012
Last updated
10/21/2012
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