Dr. Shelley K Watters
Internist - Allergy & Immunology
1055 N Mayfair Rd
Wauwatosa
, Wisconsin 53226-3436
Dr. Shelley K Watters
Internist - Allergy & Immunology
1055 N Mayfair Rd
Wauwatosa
, Wisconsin 53226-3436
(414) 671-8860
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About
Features
Specialties
- Internist - Allergy & Immunology
Languages spoken
- English
Location
First Address
- Dr. Shelley K Watters
- 3301 W Forest Home Ave
- Milwaukee, WI
- Zip : 53215-2843
- Fax : (414) 671-8860
- Phone : (414) 647-6326
Second Address
- Dr. Shelley K Watters
- 1055 N Mayfair Rd
- Wauwatosa, WI
- Zip : 53226-3436
- Phone : (414) 479-2300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0201X | Internist - Allergy & Immunology | 3394 | WI |
National Provider Identifier
| NPI | 1407963457 |
|---|---|
| Provider Name | Dr. Shelley K Watters |
| First Address | Milwaukee, WI 53215-2843 |
| Second Address | Wauwatosa, WI 53226-3436 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/08/2006 |
| Last Update Date | 23/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 31931600 | (05) | WI |
| BW2916748 | DEA NUMBER (01) | |
| F55692 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.