Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Shorewood Family Medical Clinic SC

Organization Family Medicine Physician · NPI 1770644346

Shorewood Family Medical Clinic SC provides Family Medicine Physician services in Kenosha, Wisconsin. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

4400 Sheridan Rd
Kenosha, WI 53140-5747
Phone: (262) 652-5454
Fax: (262) 652-5732
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1770644346
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Hubbard — President · (262) 652-5454
NPI enumeratedDecember 13, 2006
Last updated in NPPESAugust 22, 2020
Mailing address4400 Sheridan Rd, Kenosha, WI 53140-5747

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