Individual
DR. ALTAMASH TARIQ IFTIKHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9697 SAINT CATHERINES DR, KENOSHA, WI 53158-2118
(262) 577-8320
(262) 577-8372
Mailing address
6308 8TH AVE STE 105, KENOSHA, WI 53143-5031
(262) 577-8320
(262) 577-8372
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
81755
WI
207Q00000X
Family Medicine Physician
OS12908
FL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
81755
WI
207QS0010X
Sports Medicine (Family Medicine) Physician
OS12908
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2013
Last updated
01/29/2025
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