Healthcare Provider Details

I. General information

NPI: 1659340735
Provider Name (Legal Business Name): RICHARD M SHUEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 N HIGH POINT RD
MADISON WI
53717-2236
US

IV. Provider business mailing address

752 N HIGH POINT RD
MADISON WI
53717-2236
US

V. Phone/Fax

Practice location:
  • Phone: 608-824-4000
  • Fax: 608-824-4938
Mailing address:
  • Phone: 608-824-4000
  • Fax: 608-824-4938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD00048863
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD00048863
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD151136
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD151136
License Number StateOR
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number75603-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: