Provider Demographics
NPI:1992840227
Name:MILWAUKEE CARDIAC CARE
Entity Type:Organization
Organization Name:MILWAUKEE CARDIAC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAQSOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-442-5400
Mailing Address - Street 1:5434 W CAPITOL DR
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2298
Mailing Address - Country:US
Mailing Address - Phone:414-442-5400
Mailing Address - Fax:414-442-5468
Practice Address - Street 1:5434 W CAPITOL DR
Practice Address - Street 2:SUITE # 1
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2298
Practice Address - Country:US
Practice Address - Phone:414-442-5400
Practice Address - Fax:414-442-5468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33146-020174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31980200Medicaid
WI31980200Medicaid
WI73029Medicare ID - Type UnspecifiedIDENTIFIER