Individual
IJAZ MOHAMMAD KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6026 W LISBON AVE, MILWAUKEE, WI 53210-2114
(414) 334-9715
Mailing address
3046 S 13TH ST, MILWAUKEE, WI 53215-3826
(414) 649-9696
(414) 649-9698
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
34065-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32151400
—
WI
Enumeration date
03/14/2007
Last updated
07/08/2007
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