Ageless Wellness Center, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

51008 Issued in WI

Legal business name

AGELESS WELLNESS CENTER, INC

Practice address

2745 W Layton Ave
Suite 203
Milwaukee, WI 53221-2651

Phone

(414) 475-5800

Fax

(414) 475-5400

NPI assigned

Jul 24, 2013

Last updated

May 2, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Abdullattief A Sulieman, MD

Title

President/Owner

Phone

(414) 475-5800

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1245672856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "530920639",
            "telephone_number": "414-247-9005",
            "fax_number": "414-247-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 W LAYTON AVE",
            "address_2": "SUITE 203",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212651",
            "telephone_number": "414-475-5800",
            "fax_number": "414-475-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS WELLNESS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "SULIEMAN",
        "authorized_official_first_name": "ABDULLATTIEF",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "414-475-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "WI",
            "license": "51008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Supatra A Agarwal, AA
• Ifunanya Agbim, MD
• Anthony Agee
• Bidgette Agee
• Ageless Living, LLC
• Anshu Aggarwal
• Robert Agnew Jr., EMT
• Atul Kumar Agrawal
• Dilpesh S Agrawal, M.D, MRCP
• Rishav Agrawal, MD

• General Practice Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• General Practice Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.