Provider Demographics
NPI:1356334817
Name:PALEY, SHARYL (MD)
Entity type:Individual
Prefix:
First Name:SHARYL
Middle Name:
Last Name:PALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARYL
Other - Middle Name:
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9000 W. WISCONSIN AVENUE
Mailing Address - Street 2:MS 958
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-7615
Mailing Address - Fax:414-266-6238
Practice Address - Street 1:7950 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:FOX POINT
Practice Address - State:WI
Practice Address - Zip Code:53217-3131
Practice Address - Country:US
Practice Address - Phone:414-228-0099
Practice Address - Fax:414-540-0165
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI35604208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1356334817Medicaid
WI32203100Medicaid
WI01750Medicare ID - Type Unspecified