| Doctor Name: | SHAHADA GHALEB SHALASH |
| NPI Number: | 1760479422 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 33963 |
| Business Practice Address: | 113 E 2nd St Westfield, WI - 539649101 |
| Business Phone Number: | 6082963207 |
| Business Fax Number: | 6082963207 |
| Mailing Address: | Po Box 245, WESTFIELD |
| State: | WI |
| Postal Code: | 539640245 |
| Phone Number: | 6082963207 |
| Fax Number: | 6082963207 |
| NPI Enumeration Date: | 09/28/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 33963 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |