Provider Demographics
NPI:1043325566
Name:SHULMAN, KAREN ANN (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:LUKASIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3205 GLACIER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-1765
Mailing Address - Country:US
Mailing Address - Phone:608-268-6211
Mailing Address - Fax:608-620-0242
Practice Address - Street 1:3205 GLACIER RIDGE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-1765
Practice Address - Country:US
Practice Address - Phone:608-268-6211
Practice Address - Fax:608-620-0242
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32460900Medicaid
WI32460900Medicaid