Provider Demographics
NPI:1689625105
Name:BASIR, ZAINAB (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAINAB
Middle Name:
Last Name:BASIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6966
Mailing Address - Fax:414-805-6980
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6966
Practice Address - Fax:414-805-6980
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI40393207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1689625105Medicaid
002000227GOtherHUMANA
WI32477600Medicaid
WI015268086Medicare ID - Type UnspecifiedWAUKESHA COUNTY
WI1689625105Medicaid
WI072H73601Medicare ID - Type UnspecifiedMILWAUKEE COUNTY