Ekstrom, Shawn C.

Ekstrom, Shawn C. is an individual health care provider with primary practice located at 777 Algoma Blvd Radford Hall, Oshkosh WI 54901-3534. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Ekstrom, Shawn C. can be contacted via phone (920) 424-2424.

Contact Information

Primary practice address
777 Algoma Blvd Radford Hall Oshkosh WI 54901-3534
Phone: (920) 424-2424
Fax: (920) 424-1769
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36923-020 Wisconsin
Allopathic & Osteopathic Physicians / Surgery 208600000X 36923-020 Wisconsin

Profile Details

NPI number 1134120033
LBN Legal business name Ekstrom, Shawn C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Jun 15th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134120033 NPPES
Wisconsin MEDICAID 322111700

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