Provider Demographics
NPI:1134879034
Name:HAIDER, SYED BASIT (MBBS)
Entity type:Individual
Prefix:DR
First Name:SYED BASIT
Middle Name:
Last Name:HAIDER
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 W KINNICKINNIC RIVER PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3631
Mailing Address - Country:US
Mailing Address - Phone:414-649-6780
Mailing Address - Fax:414-649-6030
Practice Address - Street 1:2801 W KINNICKINNIC RIVER PKWY STE 260
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3631
Practice Address - Country:US
Practice Address - Phone:414-649-6780
Practice Address - Fax:414-649-6030
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI85853-20207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program