Provider Demographics
NPI:1669449203
Name:ALLAQABAND, SUHAIL QADIR (MD)
Entity Type:Individual
Prefix:
First Name:SUHAIL
Middle Name:QADIR
Last Name:ALLAQABAND
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 2040
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-2040
Mailing Address - Country:US
Mailing Address - Phone:414-649-3370
Mailing Address - Fax:414-649-3278
Practice Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Practice Address - Street 2:SUITE 777
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215
Practice Address - Country:US
Practice Address - Phone:414-649-3370
Practice Address - Fax:414-649-3278
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39001-020207R00000X, 207RI0011X
WI39001207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32477500Medicaid
WI001446515Medicare PIN
001460350Medicare PIN
WI001440245Medicare PIN
001404130Medicare PIN
WI32477500Medicaid
G89630Medicare UPIN