Individual
DR. REZA SHAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF GASTROENTEROLOGY, MILWAUKEE, WI 53226-3522
(414) 955-6840
(414) 955-6215
Mailing address
9200 W WISCONSIN AVE, DIVISION OF GASTROENTEROLOGY, MILWAUKEE, WI 53226-3522
(414) 955-6840
(414) 955-6215
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
27320
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000135N
HUMANA
—
05
—
1033161989
—
WI
Enumeration date
05/17/2006
Last updated
09/29/2014
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