Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 62574 | WI |
NPI | 1306018007 |
---|---|
Provider Name | Dr. Rashad H Khazi Syed |
First Address | Glendale, WI 53212-1082 |
Second Address | Milwaukee, WI 53211-2984 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2008 |
Last Update Date | 26/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110F336360 | BCBSM (01) | MI |
1346398971 | GRP NPI (01) | MI |
5359802 | (05) | MI |
RK083913 | LICENSE (01) | MI |