Healthcare Provider Details

I. General information

NPI: 1861461626
Provider Name (Legal Business Name): REHANA BEGUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 W KINNICKINNIC RIVER PKWY STE 530
MILWAUKEE WI
53215-3669
US

IV. Provider business mailing address

2900 W OKLAHOMA AVE 5TH FL GALLERIA
MILWAUKEE WI
53215-4330
US

V. Phone/Fax

Practice location:
  • Phone: 414-649-5534
  • Fax:
Mailing address:
  • Phone: 414-646-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number62224
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number62224
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: