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Individual

OSAMA ELTAYEB MOHAMMED ELKHIDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-0350
(414) 805-0855
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-0350
(414) 805-0855

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
80017
WI
208M00000X
Hospitalist Physician
Primary
80017
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215582382
WI
Enumeration date
08/06/2019
Last updated
03/15/2023
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