Individual
DR. MOHSIN YUNUS GHADIALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(414) 290-6720
(414) 290-6755
Mailing address
6 N PARK ST, WATERTOWN, MA 02472-2561
(630) 991-6713
(630) 991-6713
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
63593-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01698310
RAILROAD MEDICARE
WI
Enumeration date
03/31/2010
Last updated
04/10/2020
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