Individual
MUSTAFA SYED AZIMUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4328 OLD GREEN BAY RD, MOUNT PLEASANT, WI 53403-9489
(262) 687-7606
Mailing address
4328 OLD GREEN BAY RD, MOUNT PLEASANT, WI 53403-9489
(262) 687-7606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
73923
WI
390200000X
Student in an Organized Health Care Education/Training Program
125070421
IL
Other
Enumeration date
06/01/2017
Last updated
01/03/2025
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