Watters, Shelley K

Watters, Shelley K is an individual health care provider with primary practice located at 36500 Aurora Dr , Summit WI 53066-4899. She recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as her primary health care specialty. Watters, Shelley K can be contacted via phone (262) 434-1000.

Contact Information

Primary practice address
36500 Aurora Dr Summit WI 53066-4899
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207RA0201X 3394 Wisconsin

Profile Details

NPI number 1407963457
LBN Legal business name Watters, Shelley K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Jun 5th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407963457 NPPES
Wisconsin MEDICAID 31931600

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