Provider Demographics
NPI:1841573334
Name:NOOR HOSPITALIST, LLC
Entity Type:Organization
Organization Name:NOOR HOSPITALIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AIJAZ
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:NOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-649-3325
Mailing Address - Street 1:4587 W ALANNA CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8698
Mailing Address - Country:US
Mailing Address - Phone:414-618-3325
Mailing Address - Fax:414-649-5158
Practice Address - Street 1:4587 W ALANNA CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8698
Practice Address - Country:US
Practice Address - Phone:414-618-3325
Practice Address - Fax:414-649-5158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33338400Medicaid
WI33338400Medicaid