Individual
DR. AHMAD A MAQBOUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5400
Mailing address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301104344
MI
207Q00000X
Family Medicine Physician
Primary
6626-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/22/2013
Last updated
04/10/2019
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