Provider Demographics
NPI:1861476624
Name:NOOR, AIJAZ AHMED (MD)
Entity Type:Individual
Prefix:MR
First Name:AIJAZ
Middle Name:AHMED
Last Name:NOOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Mailing Address - Street 2:SUITE 730
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3669
Mailing Address - Country:US
Mailing Address - Phone:414-649-7202
Mailing Address - Fax:414-649-5158
Practice Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Practice Address - Street 2:SUITE 730
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3669
Practice Address - Country:US
Practice Address - Phone:414-649-7202
Practice Address - Fax:414-649-5158
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI41404-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41404-020OtherLICENSE
WI110232522OtherRAILROAD MEDICARE
WI33338400Medicaid
WI33338400Medicaid
WI33338400Medicaid
WI301230Medicare ID - Type Unspecified
WIH17266Medicare UPIN