Provider Demographics
NPI:1003055302
Name:ALQWASMI, ABDEL HAI ISMAIL (MD)
Entity Type:Individual
Prefix:
First Name:ABDEL HAI
Middle Name:ISMAIL
Last Name:ALQWASMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 PLEASANT VALLEY RD
Mailing Address - Street 2:DIVISION OF NEOPLASTIC DISEASES
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-9274
Mailing Address - Country:US
Mailing Address - Phone:262-836-7200
Mailing Address - Fax:262-306-7851
Practice Address - Street 1:3200 PLEASANT VALLEY RD
Practice Address - Street 2:DIVISION OF NEOPLASTIC DISEASES
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-9274
Practice Address - Country:US
Practice Address - Phone:262-836-7200
Practice Address - Fax:262-306-7851
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092523207R00000X
WI62404207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1003055302Medicaid