Organization
FAMILY PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZAIGHAM ULLAH TAHIR DO (PRESIDENT)
(262) 564-0611
Entity
Organization
Contact information
Practice address
3601 30TH AVE, KENOSHA, WI 53144-1695
(262) 564-0611
Mailing address
3601 30TH AVE, KENOSHA, WI 53144-1695
(262) 564-0611
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
036.102772
IL
261QP2300X
Primary Care Clinic/Center
Primary
45299-021
WI
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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