Individual
DR. BABAK SERUSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-7970
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
72593
WI
Other
Enumeration date
05/12/2017
Last updated
02/02/2021
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