Individual
COREY JUSTIN SHAMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
45708020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34771800
—
WI
01
—
P00474684
RR MEDICARE
WI
Enumeration date
10/03/2006
Last updated
10/31/2023
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