Individual
ALI KHAN DAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MEDICAL PKWY STE 210, LAKEWAY, TX 78738-1793
(512) 654-1234
(512) 654-0321
Mailing address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
(262) 334-3451
(262) 347-3044
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
3510
WI
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
3510
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558659490
—
WI
Enumeration date
07/13/2011
Last updated
11/21/2023
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