Individual
DR. LAITH MUTASEM AL-SHIHABI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
N15W28300 GOLF RD, PEWAUKEE, WI 53072
(262) 303-5055
(262) 303-5006
Mailing address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5055
(262) 303-5057
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
125-058682
IL
207X00000X
Orthopaedic Surgery Physician
65234
WI
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
65234
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861713265
—
WI
Enumeration date
06/20/2010
Last updated
03/12/2026
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