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Individual

JUVARIA SHAHABUDDIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
12225 71ST ST, KENOSHA, WI 53142-7320
(877) 666-7223
(262) 948-4841
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
67758
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100071395
WI
Enumeration date
04/05/2012
Last updated
12/12/2023
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