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MR. ABDULLATTIEF ABDULAZIZ SULIEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1672 S 9TH ST, MILWAUKEE, WI 53204-3426
(414) 645-9711
(414) 645-9211
Mailing address
PO BOX 639, THIENSVILLE, WI 53092-0639
(414) 645-9711
(414) 645-9211

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
51008-020
WI
208D00000X
General Practice Physician
Primary
51008-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881864197
WI
01
K100110473
MEDICARE PTAN AGELESS
WI
01
K400111699
MEDICARE PTAN AGELESS
WI
01
WI1640
MEDICARE PTAN
WI
01
WI1640001 IND
MEDICARE PTAN
WI
Enumeration date
03/04/2008
Last updated
05/19/2015
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