Shirin Yusubov, MD | |
975 Port Washington Rd, Grafton, WI 53024-9201 | |
(262) 329-1000 | |
Not Available |
Full Name | Shirin Yusubov |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 975 Port Washington Rd, Grafton, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396360848 | NPI | - | NPPES |
100291328 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 4301507357 (Michigan) | Secondary |
207L00000X | Anesthesiology | 84720 (Wisconsin) | Primary |
Entity Name | Aurora Medical Group, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Mailing Address | Practice Location Address |
---|---|
Shirin Yusubov, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Shirin Yusubov, MD 975 Port Washington Rd, Grafton, WI 53024-9201 Ph: (262) 329-1000 |
Taylor L Gatlin, Anesthesiology Medicare: Medicare Enrolled Practice Location: 975 Port Washington Rd, Grafton, WI 53024 Phone: 262-329-1000 Fax: 262-329-1001 | |
Man Dick Young, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 975 Port Washington Rd, Grafton, WI 53024 Phone: 262-329-2135 Fax: 262-329-3151 | |
Dr. Ali A Sadeghi, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 975 Port Washington Rd, Grafton, WI 53024 Phone: 414-219-2000 | |
Dr. Robert J Schlosser, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 975 Port Washington Rd, Grafton, WI 53024 Phone: 262-329-1000 Fax: 262-329-1001 | |
Dr. Timothy Erik Gundlach, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 975 Port Washington Rd, Grafton, WI 53024 Phone: 262-329-2135 Fax: 262-329-3151 | |
Jeremy M Groth, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 975 Port Washington Rd, Grafton, WI 53024 Phone: 262-329-1000 Fax: 262-329-1001 |