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Individual

LAMYA BOUJELBANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D., MPH

Contact information

Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000
Mailing address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
55724
WI
207RN0300X
Nephrology Physician
Primary
55724
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100023756
WI
Enumeration date
04/07/2009
Last updated
11/24/2021
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