Individual
GHAZAN JALIL MIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 250, MILWAUKEE, WI 53215-3678
(414) 649-6732
(414) 649-5840
Mailing address
2801 W KINNICKINNIC RIVER PKWY STE 250, MILWAUKEE, WI 53215-3678
(414) 649-6732
(414) 649-5840
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
85389-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
03/22/2023
Last updated
05/19/2025
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