Organization
HEMATOLOGY ONCOLOGY SPECIALTY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUSAM S. TARAWNEH M.D. (PRESIDENT)
(262) 968-9190
Entity
Organization
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6380
(414) 649-5389
Mailing address
N53W16184 WHITETAIL RUN, MENOMONEE FALLS, WI 53051-0628
(262) 703-0116
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
31619
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31671000
—
WI
Enumeration date
10/26/2006
Last updated
08/22/2020
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