WALTER WONG (NPI# 1023050291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023050291 |
| Entity Type | Individual |
| Full Name | WALTER WONG |
| Credential | MD |
| Practice Address |
10400 75th St Kenosha WI 53142-7884 |
| Mailing Address |
11516 N Port Washington Rd Ste 107 Mequon WI 53092-3478 |
| Practice Telephone | 2629486400 |
| Mailing Telephone | 2622415040 |
| Mailing Fax Number | 2622415261 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
28458 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 30834300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689647414 | Walter A Wong | Optometrist | 1880 S. Norfolk St., San Mateo, CA 94403 | 2006-02-10 |
| 1124013404 | Walter Khe Tian Wong | Psychiatry & Neurology | 2424 S 90th St, Suite 202, West Allis, WI 53227-2455 | 2005-09-13 |
| Street Address |
10400 75TH ST |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-7884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477546737 | Mea-aea Kenosha Sc | Family Medicine | 10400 75th St, Kenosha, WI 53142-7884 | 2005-08-23 |
| 1548877707 | Megan Labine | Dietitian, Registered | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-30 |
| 1730796574 | Saralyn Paredes | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-25 |
| 1518586965 | Ariel Adelsen | Registered Nurse | 10400 75th St, Kenosha, WI 53142-7884 | 2020-04-15 |
| 1134757073 | Amber Jirschele | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-8323 | 2020-03-27 |
| 1912539974 | Kristina A Roscizewski | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-02-07 |
| 1386274413 | Ethan Nathaniel Mcfaddin | Pharmacist | 10400 75th St, Kenosha, WI 53142-7884 | 2020-01-16 |
| 1972133031 | Patricia Grzyb | Physician Assistant | 10400 75th St, Kenosha, WI 53142-7884 | 2020-01-16 |
| 1144873654 | Lauren Cornejo | Occupational Therapist | 10400 75th St, Kenosha, WI 53142-8323 | 2019-07-23 |
| 1245710771 | Brenda Joyce Woodhull | Registered Nurse | 10400 75th St, Kenosha, WI 53142-7884 | 2018-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1710938550 | Kevin A Khater | Radiology | 6308 8th Ave, Kenosha, WI 53143-5031 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922652510 | Sangjune Lee | Radiology | 710 Ridge St Apt 207, Madison, WI 53705-3641 | 2019-07-31 |
| 1225456981 | John Martin Floberg | Radiology | 2140, Med 4 Mailbox, Hslc, 750 Highland Ave., Madison, WI 53705 | 2014-03-31 |
| 1154651727 | Matthew Edward Witek | Radiology | 309 W Johnson St Apt 714, Madison, WI 53703-3553 | 2010-01-05 |
| 1558598441 | Eva Christensen | Radiology | 11516 N Port Washington Rd, Mequon, WI 53092-3441 | 2009-06-17 |
| 1265687024 | Marcia Js Richards | Radiology | 675 Park Cir, Elm Grove, WI 53122-2556 | 2008-11-20 |
| 1891888269 | Michael E Ray | Radiology | 900 E Grant, Appleton, WI 54911-3487 | 2006-09-30 |
| 1093759185 | Editha A Krueger | Radiology | 424 E Wisconsin Ave, Appleton, WI 54911-4860 | 2006-06-16 |
| 1336187251 | Laura B Ulmer | Radiology | 3809 Spring St, Racine, WI 53405-1667 | 2006-06-03 |
| 1558318782 | Linda Gemer | Radiology | 1277 Hickory Hill Dr, Green Bay, WI 54304-2363 | 2006-05-31 |
| 1609822774 | Darryl R Barton | Radiology | 215 N 28th Ave, Wausau, WI 54401-4100 | 2006-05-26 |
| Find all providers with the same taxonomy | ||||
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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.