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Individual

MOHAMMAD EYMAN MORTADA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 777, MILWAUKEE, WI 53215-3669
(414) 649-3390
(414) 649-5769
Mailing address
PO BOX 2040, MILWAUKEE, WI 53201-2040
(414) 649-3390
(414) 649-5769

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
43167-020
WI
207RC0000X
Cardiovascular Disease Physician
43167-020
WI
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
43167-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34173300
WI
Enumeration date
06/18/2007
Last updated
06/23/2022
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