Individual
MAZEN A ALKHALISY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
704 S WEBSTER AVE, GREEN BAY, WI 54301-3528
(920) 433-3784
Mailing address
704 S WEBSTER AVE, GREEN BAY, WI 54301-3528
(920) 433-3784
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44696
WI
Other
Enumeration date
12/06/2005
Last updated
03/24/2014
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