Individual
DR. ELTON MUSTAFARAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-6000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
66935-21
WI
2085R0202X
Diagnostic Radiology Physician
66935-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100068699
—
WI
Enumeration date
06/27/2012
Last updated
02/11/2025
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