Healthcare Provider Details

I. General information

NPI: 1326477233
Provider Name (Legal Business Name): AASIM MOHAMMED M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2013
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 N DODGE ST STE 201
BURLINGTON WI
53105-1963
US

IV. Provider business mailing address

PO BOX 933
HALES CORNERS WI
53130-0933
US

V. Phone/Fax

Practice location:
  • Phone: 414-672-9940
  • Fax:
Mailing address:
  • Phone: 414-427-7820
  • Fax: 414-427-7824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT204375
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number66819-20
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number66819-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: