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General NPI Number Information
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NPI Number | 1205657418
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Entity Type | Individual
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Provider Name | HADEER MAHMOUD MAHMOUD EMEIRA
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Gender | Female
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 136 N MAIN ST
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City | THIENSVILLE
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State | WI
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Zip | 53092-1606
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Country | US
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Telephone | 262-429-9429
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Fax | 262-429-9428
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Provider Business Mailing Address
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Address Line | 1933 N PROSPECT AVE APT 302
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City | MILWAUKEE
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State | WI
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Zip | 53202-7202
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Country | US
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Telephone | 216-816-4437
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 23348541
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License Number State | WI
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