Individual
SHAILAJA MUNAGALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1910 ALABAMA STREET, STURGEON BAY, WI 54235-3532
(920) 530-3502
Mailing address
1910 ALABAMA STREET, STURGEON BAY, WI 54235-3532
(920) 530-5302
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5643020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538470604
—
WI
Enumeration date
06/23/2010
Last updated
10/15/2012
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