Individual
DR. SHANE A SOLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
S30W24896 SUNSET DR, SUITE 105, WAUKESHA, WI 53189-7021
(262) 542-5295
(262) 542-5641
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2334
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38587900
—
WI
01
—
391985642
BLUE CROSS BLUE SHIELD
WI
Enumeration date
10/24/2005
Last updated
06/21/2022
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