Individual
DR. NATASHA RAE SHALLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2323 N LAKE DR, ROOM W1094, MILWAUKEE, WI 53211-4508
(414) 291-1994
Mailing address
4425 N PORT WASHINGTON RD, GLENDALE, WI 53212-1082
(414) 326-2218
(414) 326-2208
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
62889
WI
Other
Enumeration date
06/14/2010
Last updated
09/04/2014
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