Individual
SHAWN DOUGLAS ANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BELOIT MEMORIAL HOSPITAL, 1969 W. HART ROAD, BELOIT, WI 53511-2230
(608) 363-5971
(608) 363-5737
Mailing address
BELOIT HEALTH SYSTEM INC., 1905 E. HUEBBE PARKWAY, BELOIT, WI 53511-1842
(608) 364-2200
(608) 363-7395
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
46666020
WI
208M00000X
Hospitalist Physician
Primary
46666-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163922
—
WI
05
—
34513100
—
WI
Enumeration date
07/27/2006
Last updated
02/28/2018
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