Individual
MOHAMMAD R JAZAYERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
744 S WEBSTER AVE, 2ND FLOOR, GREEN BAY, WI 54301-3505
(920) 433-3640
(920) 433-3716
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
27239
WI
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
27239-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30770600
—
WI
Enumeration date
10/12/2006
Last updated
11/28/2023
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