Individual
MARIUM KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MPH
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 802-2100
(920) 802-1500
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
70086
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
70086
WI
207RP1001X
Pulmonary Disease Physician
Primary
70086
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100082372
—
WI
05
—
1922539493
—
WI
Enumeration date
03/25/2017
Last updated
08/20/2024
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