Healthcare Provider Details

I. General information

NPI: 1710377429
Provider Name (Legal Business Name): SHER XIONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2015
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12735 W CAPITOL DR
BROOKFIELD WI
53005-2442
US

IV. Provider business mailing address

12735 W CAPITOL DR
BROOKFIELD WI
53005-2442
US

V. Phone/Fax

Practice location:
  • Phone: 262-783-7302
  • Fax: 262-783-7513
Mailing address:
  • Phone: 262-783-7302
  • Fax: 262-783-7513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number15628-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: