Provider Demographics
NPI:1821418583
Name:KAUSAR, HENA (MD)
Entity Type:Individual
Prefix:
First Name:HENA
Middle Name:
Last Name:KAUSAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 VOLD CT
Mailing Address - Street 2:APT 1
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-4109
Mailing Address - Country:US
Mailing Address - Phone:608-322-2405
Mailing Address - Fax:
Practice Address - Street 1:3102 VOLD CT
Practice Address - Street 2:APT 1
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-4109
Practice Address - Country:US
Practice Address - Phone:608-322-2405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57170-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine