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NPI Code Detail

MEDICARE: ALI O ARTAR MD

MEDICARE: ALI O ARTAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084S0012XSleep Medicine (Psychiatry & Neurology) Physician01064085AIN
22084P0800XPsychiatry Physician67996-20WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000533634OTHERINANTHEM BXBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538156369
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALI O ARTAR MD
Provider Business Mailing Address
First Line : 7330 W LAYTON AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53220-3849
Country : US
Telephone Number : 414-817-8896
Fax Number : 414-817-8940
Provider Business Practice Location Address
First Line : 7330 W LAYTON AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53220-3849
Country : US
Telephone Number : 414-817-8896
Fax Number : 414-817-8940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 10/22/2019

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