Healthcare Provider Details

I. General information

NPI: 1790307080
Provider Name (Legal Business Name): RIHAWI MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 05/11/2020
Certification Date: 05/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 W KINNICKINNIC RIVER PKWY STE 445
MILWAUKEE WI
53215-3669
US

IV. Provider business mailing address

6400 INDUSTRIAL LOOP
GREENDALE WI
53129-2452
US

V. Phone/Fax

Practice location:
  • Phone: 414-649-5288
  • Fax: 414-649-5875
Mailing address:
  • Phone: 414-858-4106
  • Fax: 414-423-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MOUHAMMED RIHAWI
Title or Position: OWNER
Credential: MD
Phone: 414-649-5288