Individual
DANIEL SHUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209
(414) 352-3100
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3824
WI
363AM0700X
Medical Physician Assistant
3824-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100062895
—
WI
Enumeration date
08/06/2016
Last updated
11/22/2021
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