Organization
MEHRAN HEYDARPOUR, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEHRAN HEYDARPOUR M.D. (PRESIDENT)
(262) 787-5095
Entity
Organization
Contact information
Practice address
19875 KILLARNEY WAY, BROOKFIELD, WI 53045-2138
(262) 787-5095
Mailing address
PO BOX 1413, BROOKFIELD, WI 53008-1413
(262) 787-5095
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31550100
—
WI
Enumeration date
12/17/2006
Last updated
08/22/2020
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