Shawn Sanjeev Shukla, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

73151-20 Issued in WI

Practice address

2323 N Lake Dr
Milwaukee, WI 53211-4508

Phone

(414) 585-1620

NPI assigned

Apr 1, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1235592619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4953 S HAWTHORNE CT",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517662",
            "telephone_number": "414-213-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114508",
            "telephone_number": "414-585-1620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2006 Hogback Road, Suite 1",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48105",
            "country_code": "US",
            "telephone_number": "734-786-2300",
            "fax_number": "734-786-4915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "SHAWN",
        "middle_name": "SANJEEV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "73151-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Shuda, RPH
• Daniel Shuder, PA-C
• Abhishek Shukla, M.D.
• Monica Erin Shukla
• Neehal Shukla, MD
• Sara Mildred Shuler, RKT
• Elissa Shulta, DNP, RN
• Axel G Shum
• Robert Shumaker, RPH
• Kyle Theodore Shuman

• Psychiatry Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.