Individual
DR. UDAYA SHREESHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 MINISTRY PKWY, WESTON, WI 54476-5220
(715) 393-3000
Mailing address
3400 MINISTRY PKWY, WESTON, WI 54476-5220
(715) 393-3000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34951
IA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036136134
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
34951
IA
207RP1001X
Pulmonary Disease Physician
036136134
IL
207RP1001X
Pulmonary Disease Physician
34951
IA
207RP1001X
Pulmonary Disease Physician
35.125679
OH
207RP1001X
Pulmonary Disease Physician
Primary
61-320
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0281071
—
IA
Enumeration date
05/31/2006
Last updated
06/24/2020
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