Individual
ANN J SHALLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
N57W24950 N CORPORATE CIR, PROHEALTH CARE MEDICAL ASSOCIATES INC., SUSSEX, WI 53089-4383
(262) 820-3093
(262) 532-9598
Mailing address
N17W24100 RIVERWOOD DR STE 250, PROHEALTH CARE MEDICAL ASSOCIATES INC., WAUKESHA, WI 53188-1177
(262) 928-4100
(262) 928-5835
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46929
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43520600
—
WI
Enumeration date
02/10/2006
Last updated
11/15/2011
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