Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M8591 | TX |
N | 111NI0900X | Internist | M8591 | TX |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 59941 | WI |
NPI | 1255358743 |
---|---|
Provider Name | Omar Mukhtar Cheema |
First Address | Milwaukee, WI 53215-4330 |
Second Address | Milwaukee, WI 53215-4330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 03/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
197983301 | (05) | TX |
197983303 | (05) | TX |
197983304 | (05) | TX |
2131048 | (05) | MA |
8AH675 | BLUE CROSS BLUE SHIELD (01) | TX |
I60415 | (02) | MA |
J40893 | BLUE SHIELD (01) | MA |