Mirza, Shazia
Mirza, Shazia is an individual health care provider with primary practice located at 1020 35Th St , Kenosha WI 53140-1902. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Mirza, Shazia can be contacted via phone (262) 652-3500.Contact Information
Primary practice address
1020 35Th St
Kenosha WI 53140-1902
Phone: (262) 652-3500
Fax: (262) 925-8353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-115477 | Illinois |
Profile Details
| NPI number | 1972547040 |
|---|---|
| LBN Legal business name | Mirza, Shazia |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Apr 25th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972547040 | NPPES |
| Wisconsin | Other | 83832 | DEAN S.E. MEDICAID |
| Wisconsin | Other | 1069731001 | DEAN S.E. MEDICAID |
| Wisconsin | Other | 83832 | DEAN S.E. MEDICAID |
| Wisconsin | MEDICAID | 34738600 | DEAN S.E. MEDICAID |
| Wisconsin | Other | 0622304 | DEAN S.E. MEDICAID |
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