Individual
BASHIR MOHAMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2110 W LAYTON AVE APT 138, MILWAUKEE, WI 53221-2758
(312) 483-4043
Mailing address
2110 W LAYTON AVE APT 138, MILWAUKEE, WI 53221-2758
(312) 483-4043
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M530-0617-9001-06
WI
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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