Individual
SHASHI BHUSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 549-5000
Mailing address
1029 KUFRIN WAY, LOMBARD, IL 60148-3429
(773) 383-9298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49709
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34732800
—
WI
Enumeration date
09/24/2006
Last updated
11/23/2021
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