Healthcare Provider Details
I. General information
NPI: 1356334817
Provider Name (Legal Business Name): SHARYL PALEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/30/2005
Last Update Date: 01/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7950 N PORT WASHINGTON RD
FOX POINT WI
53217-3131
US
IV. Provider business mailing address
9000 W. WISCONSIN AVENUE MS 958
MILWAUKEE WI
53226-4874
US
V. Phone/Fax
- Phone: 414-228-0099
- Fax: 414-540-0165
- Phone: 414-266-7615
- Fax: 414-266-6238
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 35604 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: