Individual
MR. DOUGLAS R. SHEARER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
(608) 324-1246
Mailing address
N204 POTTAWATOMI TRL, MILTON, WI 53563-9501
(906) 458-0198
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
055770
MI
208D00000X
General Practice Physician
49875-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356594691
MEDICARE GR UPIN
MI
01
—
1770562332
MEDICARE INDIVIDUAL PTAN
MI
05
—
2805583
—
MI
05
—
3475858
—
MI
01
—
MI1247
MEDICARE GROUP PTAN
MI
01
—
MI1247001
INDIVIDUAL PTAN
MI
Enumeration date
01/12/2006
Last updated
03/24/2021
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