Individual
MUSAB EM T NUSRAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
Mailing address
3601 4TH ST, MS 9410, LUBBOCK, TX 79430-9410
(806) 743-3155
(806) 743-3143
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
68185-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/08/2011
Last updated
10/26/2018
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