Individual
DR. ANNALIESE MARIE KOLLER SHUMATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1155 N MAYFAIR RD, 3RD FLOOR, DEPARTMENT OF PSYCHIATRY, WAUWATOSA, WI 53226-3462
(414) 955-8990
Mailing address
1155 N MAYFAIR RD, 3RD FLOOR, DEPARTMENT OF PSYCHIATRY, WAUWATOSA, WI 53226-3462
(414) 955-8990
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
60433-21
WI
Other
Enumeration date
04/07/2011
Last updated
10/17/2013
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