Individual
SHAHADA GHALEB SHALASH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 E 2ND ST, WESTFIELD, WI 53964-9101
(608) 296-3207
(608) 296-3207
Mailing address
PO BOX 245, WESTFIELD, WI 53964-0245
(608) 296-3207
(608) 296-3207
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
33963
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31889100
—
WI
Enumeration date
09/28/2005
Last updated
07/08/2007
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