SHAWN C. EKSTROM MD NPI 1134120033

NPI Information

NPI: 1134120033
Provider Name: SHAWN C. EKSTROM, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
777 ALGOMA BLVD
RADFORD HALL
OSHKOSH, WI
ZIP 54901
Phone: (920) 424-2424
Get Directions

Shawn C. Ekstrom, MD is a family medicine in Oshkosh, WI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Shawn C. Ekstrom, MD NPI is 1134120033. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

777 ALGOMA BLVD
RADFORD HALL
OSHKOSH, WI
ZIP 54901-534
Phone: (920) 424-2424
Fax: (920) 424-1769

The enumeration date for this NPI number is 8/2/2005 and was last updated on 6/15/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		36923-020	WISCONSIN	No
2	207Q00000X	Family Medicine		36923-020	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	008700416	MEDICARE PIN
2	G25828	MEDICARE UPIN	WISCONSIN
3	322111700	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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