Individual
MR. HESHAM HAFEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 BRUMBACK BLVD, KENOSHA, WI 53144-4815
(262) 654-6854
Mailing address
3300 BRUMBACK BLVD, KENOSHA, WI 53144-4815
(262) 654-6854
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19234-40
WI
Other
Enumeration date
10/15/2020
Last updated
11/05/2020
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