TADEO A DIAZ BALDERRAMA (NPI# 1437458817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437458817 |
| Entity Type | Individual |
| Full Name | TADEO A DIAZ BALDERRAMA |
| Credential | MD |
| Practice Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209268230 |
| Practice Fax Number | 9209268997 |
| Mailing Telephone | 9209268230 |
| Mailing Fax Number | 9209268997 |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2018-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
59901 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
420 E DIVISION ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760489017 | Ronald Eric Lilly | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-07-01 |
| 1831715721 | Agnesian Healthcare Inc | Preventive Medicine | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-17 |
| 1336783042 | Lisa Jo Liedke | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-11-05 |
| 1932740495 | Terrina Kay Goeden | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-10-04 |
| 1801441910 | Courtney M Yenter | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-08-06 |
| 1861046591 | Kimberly Kay Hornes | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-31 |
| 1023662459 | Domenick Tirabassi Iv | Student in an Organized Health Care Education/Training Program | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-24 |
| 1497308233 | Kelly Jo Rehfeldt | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-22 |
| 1184286411 | Carley Jo Reinke | Nurse Practitioner | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2019-07-08 |
| 1255823316 | Teegan R Kraus | Physician Assistant | 420 E Division St, Fond Du Lac, WI 54935 | 2018-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962492397 | David R Bowman | Internal Medicine | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2005-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215414727 | Telemedico Physicians of Wisconsin Sc | Internal Medicine | 301 S Bedford St Ste 1, Madison, WI 53703-3691 | 2018-07-26 |
| 1649682667 | James King | Internal Medicine | 4540 S Sommerset Dr, New Berlin, WI 53151-6876 | 2014-05-26 |
| 1548686470 | Cullinane Cardiovascular Consultants, Sc | Internal Medicine | 317 N Lake Rd, Oconomowoc, WI 53066-7101 | 2014-03-17 |
| 1235492455 | David James Coulter | Internal Medicine | 2025 W Oklahoma Ave Ste 105, Milwaukee, WI 53215-4455 | 2012-06-21 |
| 1619234937 | Daniel R Harland | Internal Medicine | 2801 W Kinnickinnic River Pkwy Ste 880, Milwaukee, WI 53215-3678 | 2012-04-12 |
| 1295053106 | Setu D Trivedi | Internal Medicine | 10400 75th St Ste 212, Kenosha, WI 53142 | 2010-05-17 |
| 1336467554 | Expert Care Inc | Internal Medicine | 1111 E Sumner St, Suite A, Hartford, WI 53027-1609 | 2010-05-12 |
| 1548582547 | Moe Zafarani | Internal Medicine | 3215 W Lawrence St Ste 3, Appleton, WI 54914-4274 | 2010-02-18 |
| 1073844932 | James Harry Thomsen | Internal Medicine | 7709 Twinflower Dr, Madison, WI 53719-4544 | 2010-01-15 |
| 1740419019 | Thomas James Karras | Internal Medicine | 212 S Turtle Bay, Elkhart Lake, WI 53020-1985 | 2009-07-08 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.