Individual
DR. FAYE E MANSOUR-SHAMMO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20611 WATERTOWN RD, SUITE C, WAUKESHA, WI 53186-1871
(262) 798-1810
(262) 798-2614
Mailing address
20611 WATERTOWN RD, SUITE C, WAUKESHA, WI 53186-1871
(262) 798-1810
(262) 798-2614
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36145
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32094000
—
WI
Enumeration date
02/01/2006
Last updated
07/08/2007
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