Provider Demographics
NPI:1689027096
Name:UNJOM, ZUBINA
Entity Type:Individual
Prefix:
First Name:ZUBINA
Middle Name:
Last Name:UNJOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805A SPRING ST STE 310
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53405-1600
Mailing Address - Country:US
Mailing Address - Phone:262-687-8115
Mailing Address - Fax:262-687-6709
Practice Address - Street 1:3805A SPRING ST STE 310
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53405-1600
Practice Address - Country:US
Practice Address - Phone:262-687-8115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7550820207RE0101X
IL125.069498207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine