Individual
DR. STUTI SHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1350 S SUNNY SLOPE RD, SUNNYSLOPE PRIMARY CARE CLINIC, BROOKFIELD, WI 53005-7060
(414) 805-9600
(414) 805-9645
Mailing address
1350 S SUNNY SLOPE RD, SUNNYSLOPE PRIMARY CARE CLINIC, BROOKFIELD, WI 53005-7060
(414) 805-9600
(414) 805-9645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
50450
WI
207R00000X
Internal Medicine Physician
D0064047
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-604-328-5
ECFMG NUMBER
—
05
—
1710099379
—
WI
Enumeration date
08/31/2006
Last updated
10/01/2014
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