Individual
DR. SHELLEY K WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
3394
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31931600
—
WI
Enumeration date
08/24/2006
Last updated
06/05/2024
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