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NPI Code Detail

MEDICARE: HAMZA IBRAHIM BAKHTIAR

MEDICARE:   HAMZA IBRAHIM BAKHTIAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramWI

General Provider Information

NPI Number : 1447193610
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAMZA IBRAHIM BAKHTIAR
Provider Business Mailing Address
First Line : 2301 N LAKE DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-4508
Country : US
Telephone Number : 414-585-1000
Fax Number : 414-585-1113
Provider Business Practice Location Address
First Line : 2301 N LAKE DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-4508
Country : US
Telephone Number : 414-585-1000
Fax Number : 414-585-1113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ HAMZA IBRAHIM BAKHTIAR ” Practice Location

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