Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 309895 | LA |
N | 111NI0900X | Internist | 309895 | LA |
N | 207R00000X | Internist | 66833-20 | WI |
N | 111NI0900X | Internist | 66833-20 | WI |
Y | 207RC0200X | Critical Care Medicine | 66833-20 | WI |
N | 207RP1001X | Pulmonary Disease | 66833 | WI |
NPI | 1003201625 |
---|---|
Provider Name | Bijan Nezami |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Summit, WI 53066-4899 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 08/02/2022 |