MICHAEL E KEEFE (NPI# 1073510004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073510004 |
| Entity Type | Individual |
| Full Name | MICHAEL E KEEFE |
| Credential | MD |
| Practice Address |
2350 N Lake Dr Suite 100 Milwaukee WI 53211-4528 |
| Mailing Address |
4425 N Port Washington Rd Attn: Csmcp Clinic Credentialing Glendale WI 53212-1082 |
| Practice Telephone | 4142987250 |
| Practice Fax Number | 4142987251 |
| Mailing Telephone | 4142987250 |
| Mailing Fax Number | 4142987251 |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2012-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
42858 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083665186 | Michael D Keefe | Dentist | 111 Torrey St, Brockton, MA 02301-4800 | 2006-05-13 |
| 1952393985 | Michael Thomas Keefe | Internal Medicine | 18302 Middlebelt Rd, Livonia, MI 48152-5007 | 2005-08-16 |
| 1720558372 | Michael Jonathan Keefe | Behavioral Analyst | 1035 Strader Dr Ste 150, Lexington, KY 40505 | 2018-11-27 |
| 1487030516 | Michael Keefe | Developmental Therapist | 33 Turnpike Rd, Southborough, MA 01772-2108 | 2015-07-30 |
| 1518034479 | Michael W. Keefe | Otolaryngology | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2006-11-29 |
| 1235221987 | Michael Brian Keefe | Counselor | 13000 Bruce B Downs Blvd, Tampa, FL 33612-4745 | 2006-09-29 |
| 1710999396 | Michael Arthur Keefe | Otolaryngology | 2929 Health Center Dr, San Diego, CA 92123-2762 | 2006-08-12 |
| 1639154297 | Michael William Keefe | Counselor | 7330 Indianapolis Blvd, Suite Two, Hammond, IN 46324-2941 | 2005-12-07 |
| Street Address |
2350 N LAKE DR SUITE 100 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194721407 | Nguyen H Phan | Internal Medicine | 2350 N Lake Dr, Ste 206, Milwaukee, WI 53211-4528 | 2005-06-22 |
| 1326650698 | Dylan Henry Menefee | Physician Assistant | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2020-08-18 |
| 1659936169 | Cadie Leigh Roszak | Nurse Practitioner | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2019-05-09 |
| 1457884165 | Shelly A. Boyd | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2017-04-10 |
| 1043663818 | Kelly Brock | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-18 |
| 1376996397 | Jennifer Gallagher | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-14 |
| 1104285873 | Catherine Bares | Nurse Practitioner | 2350 N Lake Dr, Suite 100, Milwaukee, WI 53211-4528 | 2016-02-23 |
| 1578921375 | Heather Bastjan | Nurse Practitioner | 2350 N Lake Dr, Suite 500, Milwaukee, WI 53211-4528 | 2016-02-08 |
| 1033586292 | Angela Kraus | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-08-24 |
| 1871974964 | Tatyana Trendafilova Radulovic | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-06-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326039074 | William G Matthaeus | Internal Medicine | 1055 N Mayfair Rd, Milwaukee, WI 53226-3436 | 2005-11-02 |
| 1275536450 | John Pierrus Hanson Jr. | Internal Medicine | 2901 W Kinnickinnic River Pkwy, Ste 415, Milwaukee, WI 53215-3660 | 2005-05-23 |
| 1033662432 | Bicky Thapa | Internal Medicine | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2016-08-02 |
| 1700205549 | Tyce Jeffrey Kearl | Internal Medicine | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2014-04-09 |
| 1104244458 | Eden Biltibo | Internal Medicine | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2014-04-03 |
| 1376982264 | Mandana Kamgar | Internal Medicine | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2013-06-24 |
| 1083956148 | Ariel Ann Nelson | Internal Medicine | 9200 W Wisconsin Ave, Clcc - Fifth Floor, Milwaukee, WI 53226-3522 | 2013-03-26 |
| 1073857876 | Ajit B Divgi M.d.,l.l.c. | Internal Medicine | 3267 S 16th St, Suite 208, Milwaukee, WI 53215-4500 | 2012-11-16 |
| 1104172329 | Guru Subramanian Guru Murthy | Internal Medicine | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2012-07-25 |
| 1215282264 | Aditya Varnam Shreenivas | Internal Medicine | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2012-07-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.