Individual
DR. SHIRLEY N TETTEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-0111
Mailing address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-0111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.124132
OH
207R00000X
Internal Medicine Physician
64412
WI
208M00000X
Hospitalist Physician
Primary
64412
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100046767
—
WI
05
—
1114210473
—
OH
Enumeration date
05/19/2011
Last updated
05/02/2024
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