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General NPI Number Information
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NPI Number | 1417753260
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Entity Type | Organization
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Legal Business Name | RUH LLC
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 3927 S HOWELL AVE
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City | MILWAUKEE
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State | WI
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Zip | 53207-4421
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Country | US
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Telephone | 414-687-8510
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Fax |
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Provider Business Mailing Address
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Address Line | 9246 S 44TH ST
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City | FRANKLIN
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State | WI
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Zip | 53132-9597
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Country | US
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Telephone | 414-687-8510
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMAL-EDDIN H DAHER
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Credential | PA-C
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Telephone | 414-687-8510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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