Individual
DR. MOHAMMAD SHIRDEL GERDVISHEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
Mailing address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
57.022933
OH
208600000X
Surgery Physician
Primary
69721
WI
Other
Enumeration date
10/10/2013
Last updated
12/28/2020
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