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Individual

SHANNON J. REINBOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2061 CHEYENNE COURT, GRAFTON, WI 53024-9368
(262) 376-1934
(262) 375-2076
Mailing address
4425 N PORT WASHINGTON ROAD, 3RD FLOOR, CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 326-2378
(414) 326-2155

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20339-20
WI
208000000X
Pediatrics Physician
50339-20
WI

Other

Enumeration date
12/04/2006
Last updated
03/18/2014
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