MEDICARE: MIDWEST PULMONARY CONSULTANTS LLC

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
1	207RP1001X	Pulmonary Disease Physician	37578	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659479855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST PULMONARY CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	4555 W SCHROEDER DR
Second Line	:	SUITE 170
City	:	MILWAUKEE
State	:	WI
Zip	:	53223-1496
Country	:	US
Telephone Number	:	414-365-3210
Fax Number	:	414-365-3225

Provider Business Practice Location Address
First Line	:	2741 W LAYTON AVE
Second Line	:	SUITE 201
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-2600
Country	:	US
Telephone Number	:	414-672-7343
Fax Number	:	414-672-7345

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. MUHAMMAD NADEEM
Credential	:	M.D.
Telephone Number	:	414-672-7343

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/08/2012

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