Individual
DR. WADAH JASON AYOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3100
(262) 532-9584
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3100
(262) 532-9584
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036155544
IL
207R00000X
Internal Medicine Physician
125071816
IL
207RN0300X
Nephrology Physician
036155544
IL
207RN0300X
Nephrology Physician
Primary
81087
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578058418
—
WI
Enumeration date
06/23/2018
Last updated
06/23/2023
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