Jazayeri, Mohammad R

Jazayeri, Mohammad R is an individual health care provider with primary practice located at 744 S Webster Ave 2Nd Floor, Green Bay WI 54301-3505. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Jazayeri, Mohammad R can be contacted via phone (920) 433-3640.

Contact Information

Primary practice address
744 S Webster Ave 2Nd Floor Green Bay WI 54301-3505
Phone: (920) 433-3640
Fax: (920) 433-3716
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 27239 Wisconsin
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 27239-20 Wisconsin

Profile Details

NPI number 1336238161
LBN Legal business name Jazayeri, Mohammad R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Nov 28th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336238161 NPPES
Wisconsin MEDICAID 30770600

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