Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 67087-20 | WI |
N | 2084N0402X | Child Neurologist | 67087 | WI |
NPI | 1063778900 |
---|---|
Provider Name | Dr. Nassima N Baba-Ahmed Fertikh |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-1830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2012 |
Last Update Date | 28/01/2021 |