Individual
MOOSA KALEEMULLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
116 N DODGE ST, BURLINGTON, WI 53105-1963
(414) 773-4312
(262) 763-9326
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
67294
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100070027
—
WI
Enumeration date
03/20/2013
Last updated
10/26/2023
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