Individual
THEODORE J SHINNERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2251 N SHORE DR, RHINELANDER, WI 54501-8360
(715) 361-4602
Mailing address
2251 N SHORE DR, RHINELANDER, WI 54501-8360
(715) 361-4602
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
42661
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34377100
—
WI
Enumeration date
10/26/2006
Last updated
07/08/2007
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