Individual
DR. MICHAEL JOHN SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 SHORE DR, RADIOLOGY DEPARTMENT, MARINETTE, WI 54143-4242
(715) 735-4200
(715) 735-8019
Mailing address
10335 N PORT WASHINGTON RD, SUITE 250, MEQUON, WI 53092-5763
(262) 240-9870
(262) 240-9869
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
43866-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34304300
—
WI
Enumeration date
06/30/2006
Last updated
07/08/2007
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