Provider Demographics
NPI:1235243494
Name:SUHAS K SHELGIKAR MD SC
Entity Type:Organization
Organization Name:SUHAS K SHELGIKAR MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUHAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHELGIKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-647-2899
Mailing Address - Street 1:3267 S 16TH ST
Mailing Address - Street 2:#207
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215
Mailing Address - Country:US
Mailing Address - Phone:414-647-2899
Mailing Address - Fax:414-647-1800
Practice Address - Street 1:3635 W OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4119
Practice Address - Country:US
Practice Address - Phone:414-647-2899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20533207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30109600Medicaid
B56561Medicare UPIN
WI000001322Medicare PIN