Individual
MOHAMMAD OBAIDULLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 802-2100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-8515
(920) 802-2100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
100869
WI
207Q00000X
Family Medicine Physician
OT019678
PA
207R00000X
Internal Medicine Physician
100869
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100246600
—
WI
Enumeration date
08/16/2019
Last updated
10/26/2023
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