Individual
KHAWAJA A AMMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 175, MILWAUKEE, WI 53215-3669
(414) 649-3626
(414) 385-7157
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2377
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53467
WI
207RI0011X
Interventional Cardiology Physician
Primary
53467
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34742200
—
WI
05
—
691824700
—
MN
05
—
ENROLLED
—
IA
01
—
P00391254
RAILROAD MEDICARE
MN
Enumeration date
02/17/2006
Last updated
11/19/2021
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