Provider Demographics
NPI:1407805138
Name:CARLSON, SHEILA K (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:K
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 REGENT ST
Mailing Address - Street 2:DAVIS DUEHR DEAN MEDICAL CENTER
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1248
Mailing Address - Country:US
Mailing Address - Phone:608-282-2050
Mailing Address - Fax:608-282-2217
Practice Address - Street 1:1025 REGENT ST
Practice Address - Street 2:DAVIS DUEHR DEAN MEDICAL CENTER
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1248
Practice Address - Country:US
Practice Address - Phone:608-282-2050
Practice Address - Fax:608-282-2217
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21629-020207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1837OtherDEAN HEALTH INSURANCE
WI30305500Medicaid
WI1837OtherDEAN HEALTH INSURANCE
WI050033566Medicare PIN
WI040674150Medicare PIN
WI031754340Medicare PIN