Healthcare Provider Details

I. General information

NPI: 1144276551
Provider Name (Legal Business Name): SHAHID ALI ATCHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N OAK AVE
MARSHFIELD WI
54449-5703
US

IV. Provider business mailing address

6308 8TH AVE STE 2000
KENOSHA WI
53143-5031
US

V. Phone/Fax

Practice location:
  • Phone: 715-387-5511
  • Fax:
Mailing address:
  • Phone: 262-653-5450
  • Fax: 262-653-5451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number46964
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: