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General NPI Number Information
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NPI Number | 1356520506
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Entity Type | Individual
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Provider Name | SHANNON OFFERMAN MD
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Gender | Female
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 19333 W NORTH AVE
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City | BROOKFIELD
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State | WI
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Zip | 53045-4132
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Country | US
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Telephone | 262-780-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 11516 N PORT WASHINGTON RD STE 107
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City | MEQUON
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State | WI
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Zip | 53092-3478
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Country | US
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Telephone | 262-241-5040
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Fax | 262-241-5261
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 57013998
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 55615-20
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License Number State | WI
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