Provider Demographics
NPI:1740241793
Name:HAMED, RAED A (MD)
Entity Type:Individual
Prefix:DR
First Name:RAED
Middle Name:A
Last Name:HAMED
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 639
Mailing Address - Street 2:
Mailing Address - City:THIENSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53092-0639
Mailing Address - Country:US
Mailing Address - Phone:414-247-9005
Mailing Address - Fax:414-247-9004
Practice Address - Street 1:8500 W CAPITOL DR
Practice Address - Street 2:SUITE 202B
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1869
Practice Address - Country:US
Practice Address - Phone:414-461-1133
Practice Address - Fax:414-461-1156
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46321020207RP1001X
WI46321207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34506100Medicaid
WIWI26170001Medicare Oscar/Certification
I15666Medicare UPIN