Healthcare Provider Details

I. General information

NPI: 1346482775
Provider Name (Legal Business Name): NAVEEN BILGI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2009
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 N LAKE DR ROOM 3603
MILWAUKEE WI
53211-4504
US

IV. Provider business mailing address

4425 N PORT WASHINGTON ROAD ATTN: CSMCP CLINIC CREDENTIALING
GLENDALE WI
53212-1082
US

V. Phone/Fax

Practice location:
  • Phone: 414-270-4932
  • Fax: 414-291-5195
Mailing address:
  • Phone: 414-326-2378
  • Fax: 414-326-2155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number55995
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: