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General NPI Number Information
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NPI Number | 1053672048
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Entity Type | Individual
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Provider Name | HAMID ABBAS AFSARI D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 975 PORT WASHINGTON RD
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City | GRAFTON
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State | WI
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Zip | 53024-9201
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Country | US
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Telephone | 262-329-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 975 PORT WASHINGTON RD
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City | GRAFTON
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State | WI
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Zip | 53024-9201
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Country | US
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Telephone | 262-329-1000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 75157
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101020049
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License Number State | MI
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