Individual
CHARLES PATRICK SHAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-4402
(608) 263-7502
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
73380
WI
208600000X
Surgery Physician
S1265
TX
2086S0127X
Trauma Surgery Physician
Primary
73380
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401321101
—
TX
01
—
401321102
CSHCN
TX
Enumeration date
04/27/2012
Last updated
02/08/2021
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