Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1159-25 | WI |
NPI | 1003360561 |
---|---|
Provider Name | Dr. Laith Shaman |
First Address | Milwaukee, WI 53212-3360 |
Second Address | Milwaukee, WI 53212-3360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2016 |
Last Update Date | 19/02/2020 |