Individual
BREANNE K PACHECO SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC EMERGENCY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-2625
(414) 266-2635
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC EMERGENCY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-2625
(414) 266-2635
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125055168
IL
208000000X
Pediatrics Physician
Primary
55838
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174789283
—
WI
Enumeration date
07/29/2008
Last updated
02/15/2013
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