Individual
IFREAH ALI USMAIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Mailing address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
74950
WI
207RP1001X
Pulmonary Disease Physician
74950
WI
208M00000X
Hospitalist Physician
74950
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100230711
—
WI
Enumeration date
03/19/2019
Last updated
09/25/2025
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