Individual
DR. KSHAMATA SHALINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04S962
GA
207R00000X
Internal Medicine Physician
Primary
40875-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32592000
—
WI
01
—
40875-20
WI STATE LIC
WI
Enumeration date
11/14/2005
Last updated
03/07/2023
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