Organization
INDEPENDENT PHYSICIANS OF WISCONSIN, LLC
Active
Parent organization
INDEPENDENT PHYSICIANS OF WISCONSIN, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENT PHYSICIANS OF WISCONSIN, LLC
Authorized official
MOHAMMAD QASIM KHAN MD (PARTNER)
(414) 875-0505
Entity
Organization
Contact information
Practice address
5434 W CAPITOL DR STE 3, MILWAUKEE, WI 53216-2298
(414) 875-0505
(414) 875-6786
Mailing address
5434 W CAPITOL DR STE 3, MILWAUKEE, WI 53216-2298
(414) 875-0505
(414) 875-6786
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/10/2018
Last updated
01/10/2018
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