Individual
SHIRLEY L MCCALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 HIGHLAND AVE, MAIL CODE: 1510, MADISON, WI 53792-1510
(608) 890-8298
(608) 262-1636
Mailing address
1675 HIGHLAND AVE, MAIL CODE: 1510, MADISON, WI 53792-1510
(608) 890-8298
(608) 262-1636
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
353888
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1857-29
CERTIFIED DIETITIAN
—
Enumeration date
01/20/2010
Last updated
01/20/2010
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