Individual provider · Type 1 NPI
Annaliese Marie Koller Shumate, DO
General Practice Physician · Wauwatosa, WI
NPI number
1174812499
Active
Practice location
1155 N Mayfair Rd, 3rd Floor, Department Of Psychiatry
Wauwatosa, WI 53226-3462
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 60433-21 (WI) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
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About NPI 1174812499
Annaliese Marie Koller Shumate, DO's National Provider Identifier is 1174812499, issued on Apr 7, 2011. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Wauwatosa, WI. The record was last updated on Oct 17, 2013.