Individual
SHANNON S MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
311 ELM ST, WOODRUFF, WI 54568-9149
(715) 634-9023
(715) 634-9935
Mailing address
7428 LOON LANDING SHORES, LAKE TOMAHAWK, WI 54539-9110
(877) 265-5225
(715) 277-4944
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
726-25
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
726-25
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43222500
—
WI
01
—
CG4176
RAILROAD MEDICARE
—
Enumeration date
09/22/2005
Last updated
08/23/2017
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