Organization
INDEPENDENT PHYSICIANS OF WISCONSIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD QASIM KHAN MD (MANAGING MEMBER)
(414) 875-0505
Entity
Organization
Contact information
Practice address
5434 W CAPITOL DR STE 3, MILWAUKEE, WI 53216-2298
(414) 875-0505
Mailing address
5434 W CAPITOL DR STE 3, MILWAUKEE, WI 53216-2298
(414) 875-0505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
06/25/2015
Last updated
05/06/2021
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