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General NPI Number Information
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NPI Number | 1174919039
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Entity Type | Individual
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Provider Name | AMNA SURAYA AZIZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 9000 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226-4874
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Country | US
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Telephone | 414-266-4479
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Fax |
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Provider Business Mailing Address
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Address Line | 9000 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226-4874
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 01081604A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A170480
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A170480
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 86136-20
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 34962999
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License Number State | TX
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