Individual
MARK D SHEWCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2061 CHEYENNE CT, GRAFTON, WI 53024-9368
(262) 376-1934
Mailing address
2061 CHEYENNE CT, GRAFTON, WI 53024-9368
(262) 376-1934
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28080
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31700100
—
WI
Enumeration date
07/10/2006
Last updated
01/12/2022
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