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Individual

OSMAN AHMEDTAHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177-1516
(262) 799-8700
Mailing address
PO BOX 1171, ANNANDALE, VA 22003-9171
(646) 236-8068

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101264262
VA
208M00000X
Hospitalist Physician
61923
CT
208M00000X
Hospitalist Physician
82020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100201784
WI
Enumeration date
07/24/2015
Last updated
07/29/2025
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