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Individual

FATIMA TAHERA DIABAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(586) 582-6631

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101020612
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036-163968
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
72292
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100106465
WI
Enumeration date
06/04/2013
Last updated
07/29/2025
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