Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

P Michael Shattuck, MD

Individual provider Family Medicine Physician · NPI 1740273630

P Michael Shattuck, MD is a Family Medicine Physician in Berlin, Wisconsin. Works from 2 locations. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

225 Memorial Dr
Berlin, WI 54923-1243
Phone: (920) 361-5538
Fax: (920) 361-5499
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • N2934 Highway 22, Wautoma, WI 54982-0650 — (920) 787-4613

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 25430 (WI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 25430-020 (WI)
Surgery Physician Taxonomy 208600000X · Licence 25430-020 (WI)

Record details

NPI number1740273630
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 25, 2005
Last updated in NPPESJuly 26, 2023
Certification dateJuly 26, 2023
Mailing address225 Memorial Dr, Berlin, WI 54923-1243

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