MARTIN K. WAKEHAM (NPI# 1073623260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073623260 |
| Entity Type | Individual |
| Full Name | MARTIN K. WAKEHAM |
| Credential | MD |
| Practice Address |
9000 W Wisconsin Ave Pediatric Critical Care Milwaukee WI 53226-4874 |
| Practice Telephone | 4142663360 |
| Practice Fax Number | 4142663563 |
| Mailing Telephone | 4142663360 |
| Mailing Fax Number | 4142663563 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-10-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
51779 | WI | Allopathic & Osteopathic Physicians |
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
036-103836 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036103836 | 05 | |
| WI | 1073623260 | 05 |
| Street Address |
9000 W WISCONSIN AVE PEDIATRIC CRITICAL CARE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-4874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466928 | Deborah Costakos | Ophthalmology | 9000 W Wisconsin Ave, Pediatric Ophthalmology, Milwaukee, WI 53226-4874 | 2005-06-13 |
| 1477154748 | Tara Anne Peloza | Registered Nurse | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-11-04 |
| 1518567676 | Carolyn Mcnally Scoptur | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-10-28 |
| 1053910091 | Casey Wolter | Audiologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-10-21 |
| 1558976001 | Rachel Sawdy | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-11 |
| 1205441128 | Kathleen Maloney | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-09 |
| 1992319065 | Mariia Steffeny | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-09-04 |
| 1871106575 | Elisabeth Mary Vogt | Clinical Neuropsychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-08-24 |
| 1912517277 | Theresa Lauer Kapke | Psychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-08-03 |
| 1003425380 | Khira Ahmed-yahia | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2020-07-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083675979 | Michael Thomas Meyer | Pediatrics | 9000 W Wisconsin Ave # 681, Milwaukee, WI 53226-4874 | 2006-03-30 |
| 1528324019 | Lindsey Nye Troy | Pediatrics | 8701 W Watertown Plank Rd, Milwaukee, WI 53226 | 2012-04-09 |
| 1669768008 | Nita Davis | Pediatrics | 9000 W Wisconsin Avenue, Pediatric Critical Care, Milwaukee, WI 53226-4874 | 2011-06-23 |
| 1366734501 | Adam O Szadkowski | Pediatrics | 9000 W Wisconsin Ave, Milwaukee, WI 53226 | 2011-05-06 |
| 1861711632 | Mohammed Abdulaziz Hamzah | Pediatrics | 9000 W Wisconsin Ave, Pediatric Critical Care, Milwaukee, WI 53226-4874 | 2010-05-19 |
| 1053459305 | Rebecca A. Bertrandt | Pediatrics | 9000 W Wisconsin Ave, Pediatric Critical Care, Milwaukee, WI 53226-4874 | 2007-02-01 |
| 1336253822 | Robert A. Niebler | Pediatrics | 9000 W Wisconsin Ave, Pediatric Critical Care, Milwaukee, WI 53226-4874 | 2006-08-19 |
| 1184678450 | Sheila J Hanson | Pediatrics | 9000 W Wisconsin Ave, Pediatric Critical Care, Milwaukee, WI 53226-4874 | 2006-05-20 |
| 1962456798 | Nan Norins | Pediatrics | 9000 W Wisconsin Ave, Pediatric Pulmonary Medicine, Milwaukee, WI 53226-4874 | 2006-05-19 |
| 1801849278 | Matthew C Scanlon | Pediatrics | 9000 W Wisconsin Ave, Pediatric Critical Care, Milwaukee, WI 53226-4874 | 2006-05-18 |
| Find all providers in MILWAUKEE | ||||
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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.