Organization
VALLEY NEUROLOGY CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMAD Y HAFFAR MD (PRESIDENT)
(920) 236-3201
Entity
Organization
Contact information
Practice address
555 S WASHBURN ST, OSHKOSH, WI 54904
(920) 236-3201
(920) 236-3203
Mailing address
555 S WASHBURN ST, OSHKOSH, WI 54904
(920) 236-3201
(920) 236-3203
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
23069
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21360900
—
WI
Enumeration date
02/09/2007
Last updated
08/22/2020
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