Provider Demographics
NPI:1972943744
Name:SHIGRI, SHAHID ALI (MD)
Entity Type:Individual
Prefix:
First Name:SHAHID
Middle Name:ALI
Last Name:SHIGRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 W EDGERTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4420
Mailing Address - Country:US
Mailing Address - Phone:414-325-5244
Mailing Address - Fax:414-421-3772
Practice Address - Street 1:6901 W EDGERTON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53220-4420
Practice Address - Country:US
Practice Address - Phone:414-325-5244
Practice Address - Fax:414-421-3772
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA06300207Q00000X
WI66177-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1972943744Medicaid
WIK400327904/01994Medicare PIN
WIK400327908/73975Medicare PIN
WIK400327905/46236Medicare PIN