IMTIAZ MOHAMED (NPI# 1396796884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396796884 |
| Entity Type | Individual |
| Full Name | IMTIAZ MOHAMED |
| Credential | MD |
| Practice Address |
11040 N State Road 77 Hayward WI 54843-3606 |
| Practice Telephone | 7159344321 |
| Mailing Telephone | 7159344321 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
56386 | MN | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
41063 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1396796884 | 05 | |
| MI | 1396796884 | 05 | |
| MN | 1396796884 | 05 | |
| WI | 32584300 | 05 |
| Street Address |
11040 N STATE ROAD 77 |
| City | HAYWARD |
| State | WI |
| Zip Code | 54843-3606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912992827 | Medical Services, Inc | General Acute Care Hospital | 11040 N State Road 77, Hayward, WI 54843-6391 | 2005-09-16 |
| 1962030320 | Constance M Kelsey | Speech-Language Pathologist | 11040 N State Road 77, Hayward, WI 54843-3606 | 2020-03-31 |
| 1255968418 | Kory Lutz | Physical Therapist | 11040 N State Road 77, Hayward, WI 54843-3606 | 2020-03-26 |
| 1881221059 | Erinn Greta Bratley | Occupational Therapist | 11040 N State Road 77, Hayward, WI 54843-3606 | 2020-03-26 |
| 1760034193 | Barbara L Bowman | Physician Assistant | 11040 N State Road 77, Hayward, WI 54843 | 2019-07-16 |
| 1003281809 | Ashland Audiology LLC | Clinic/Center | 11040 N State Road 77, Hayward, WI 54843-6391 | 2015-12-04 |
| 1497136428 | Andrea Yancey | Physician Assistant | 11040 N State Road 77, Hayward, WI 54843-3606 | 2015-06-16 |
| 1376954792 | Martha Krasean | Nurse Practitioner | 11040 N State Road 77, Hayward, WI 54843-3606 | 2014-05-20 |
| 1386055747 | Sarah Dums | Nurse Practitioner | 11040 N State Road 77, Hayward, WI 54843-3606 | 2014-05-19 |
| 1336405893 | Gregory Alan Lehman | Radiologic Technologist | 11040 N State Road 77, Hayward, WI 54843-6391 | 2012-04-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011252 | Kelsey Eickstaedt | Pharmacist | 15594 State Hwy 77, Hayward, WI 54843 | 2020-10-20 |
| 1245687417 | Gary Girard | Counselor | 15655 W County Hwy B, Hayward, WI 54843 | 2016-05-18 |
| 1164844379 | Elizabeth Anne Johnson | Counselor | 10594 Main Street #1021, Hayward, WI 54843 | 2014-01-08 |
| 1376776922 | Amy Marilyn Billman | Massage Therapist | 11128n Highway 27/77, Hayward, WI 54843 | 2009-08-31 |
| 1700016516 | Kyra Rhodes Larson | Dentist | 15541w Hwy 77 East, Hayward, WI 54843 | 2009-07-15 |
| 1235383985 | Sara Jane Drost | Dental Hygienist | 15910 W Company Lake Road, Hayward, WI 54843 | 2008-11-07 |
| 1982856076 | Align Therapy,llc | In Home Supportive Care | 10767 Nyman Avenue, Hayward, WI 54843 | 2008-10-21 |
| 1316112477 | Michael John Larson | Hearing Instrument Specialist | 15612 Windrose Lane, #200, Hayward, WI 54843 | 2008-04-29 |
| 1679748966 | Gwendolyn Vinopal | Physical Therapist | 16014w Sleepy Hollow Drive, Hayward, WI 54843 | 2008-04-28 |
| 1558546523 | Ruth Anne Gillmor | Social Worker | 10610 Main, Hayward, WI 54843 | 2008-01-08 |
| Find all providers in zip 54843 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265872998 | Eugene Kligman | Internal Medicine | 13133 N Port Washington Rd Ste G16, Mequon, WI 53097-2423 | 2013-06-26 |
| 1770929226 | Paul Michael Estrada | Internal Medicine | 437 N Frances St, Madison, WI 53703-2013 | 2013-05-10 |
| 1174851273 | Victor Ciofoaia | Internal Medicine | 700 West Ave South, La Crosse, WI 54601 | 2009-12-01 |
| 1255594537 | Freddy Caldera Jr. | Internal Medicine | 1685 Highland Avenue, 4256 Mfcb, Madison, WI 53705 | 2008-07-07 |
| 1457552689 | Erica Ann Samuel | Internal Medicine | 2424 S 90th St Ste 410, West Allis, WI 53227-2455 | 2007-05-28 |
| 1629157425 | Charles Cromwell | Internal Medicine | 2311 N Prospect, Milwaukee, WI 53211 | 2006-11-03 |
| 1992805832 | Suhasini Turlapati | Internal Medicine | 820 E Grant Street, Appleton, WI 54911 | 2006-09-22 |
| 1679676936 | Holy Family Memorial Inc | Internal Medicine | 800 Lakefront Way, Two Rivers, WI 54241-3301 | 2006-09-05 |
| 1639287436 | Kevin A Lang | Internal Medicine | M207 Marsh Ln, Marshfield, WI 54449-9293 | 2006-08-29 |
| 1063423515 | Joel M Carlson | Internal Medicine | 420 Dewey Street, Wisconsin Rapids, WI 54495-0005 | 2006-08-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.