Provider Demographics
NPI:1417039124
Name:IQBAL, MUHAMMAD ASIF (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:ASIF
Last Name:IQBAL
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:PO BOX 932
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-0932
Mailing Address - Country:US
Mailing Address - Phone:414-427-7820
Mailing Address - Fax:414-427-7824
Practice Address - Street 1:13880 W PRAIRIE LN
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-7509
Practice Address - Country:US
Practice Address - Phone:414-559-6685
Practice Address - Fax:414-908-1552
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46418-20207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI02120-0295Medicare PIN