Individual
MUSTAFA FAROOQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, STE 106, MILWAUKEE, WI 53215-3677
(414) 649-3300
Mailing address
2901 W KINNICKINNIC RIVER PKWY, STE 106, MILWAUKEE, WI 53215-3677
(414) 649-3300
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
44586
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34220400
—
WI
Enumeration date
09/14/2006
Last updated
12/01/2021
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