Individual
DR. SHANNON KANE RATHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 929-9300
Mailing address
PO BOX 107, FOND DU LAC, WI 54936-0107
(920) 929-9300
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
53566-20
WI
207ZH0000X
Hematology (Pathology) Physician
53566-20
WI
207ZP0101X
Anatomic Pathology Physician
Primary
53566-20
WI
Other
Enumeration date
04/12/2008
Last updated
01/09/2014
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