Individual
DR. SHIRLEY Y GODIWALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
W283N3671 YORKSHIRE TRCE, PEWAUKEE, WI 53072-3311
(262) 695-3052
Mailing address
W283N3671 YORKSHIRE TRCE, PEWAUKEE, WI 53072-3311
(262) 695-3052
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
26973
WI
208D00000X
General Practice Physician
Primary
2697320
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31392600
—
WI
01
—
340012140
RR MEDICARE
—
Enumeration date
04/04/2006
Last updated
06/25/2021
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