MICHAEL MULLANE (NPI# 1053302729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053302729 |
| Entity Type | Individual |
| Full Name | MICHAEL MULLANE |
| Credential | MD |
| Practice Address |
1151 Warwick Way Racine WI 53406-5661 |
| Mailing Address |
3003 W Good Hope Rd Milwaukee WI 53209-2042 |
| Practice Telephone | 2628867360 |
| Practice Fax Number | 2628867361 |
| Mailing Telephone | 4143523100 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2010-05-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
36700 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32142700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295251056 | Michael Patrick Mullane | Psychologist | 123 Andover Rd, Westbrook, ME 04092-3848 | 2017-08-14 |
| 1386665081 | Michael Russell Mullane | Internal Medicine | 1900 W Polk St, Room 765, Chicago, IL 60612-3723 | 2006-07-21 |
| Street Address |
1151 WARWICK WAY |
| City | RACINE |
| State | WI |
| Zip Code | 53406-5661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386838340 | Phenu V Zachariah | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2007-09-04 |
| 1518057512 | Sana Jeffreys | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2006-10-13 |
| 1265453070 | Michael Alan Thompson | Internal Medicine | 1151 Warwick Way, Aurora Health Care, Racine, WI 53406 | 2006-07-21 |
| 1417922949 | Antony Ruggeri | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2006-02-20 |
| 1588655351 | Kelly Konesko | Nurse Practitioner | 1151 Warwick Way, Racine, WI 53406-5661 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| 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 |
|---|---|---|---|---|
| 1871712083 | Young M Choi | Internal Medicine | 3809 Spring St, Racine, WI 53405-1667 | 2007-04-25 |
| 1518057512 | Sana Jeffreys | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2006-10-13 |
| 1447271549 | Richard Odders | Internal Medicine | 3809 Spring St, Racine, WI 53405-1667 | 2006-07-22 |
| 1265453070 | Michael Alan Thompson | Internal Medicine | 1151 Warwick Way, Aurora Health Care, Racine, WI 53406 | 2006-07-21 |
| 1538199401 | Michael W. Schuetz | Internal Medicine | 3809 Spring St, Racine, WI 53405-1667 | 2006-07-04 |
| 1417922949 | Antony Ruggeri | Internal Medicine | 1151 Warwick Way, Racine, WI 53406-5661 | 2006-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649716358 | Fox Valley Hematology & Oncology, S.c. | Internal Medicine | 1716 Lawrence Dr, De Pere, WI 54115-9108 | 2017-01-19 |
| 1629416409 | Christopher Robert D'angelo | Internal Medicine | 958 Basswood Ave, Verona, WI 53593-8220 | 2013-06-13 |
| 1811250426 | Michael Bade Wheeler | Internal Medicine | 28391 Essential Road, Merton, WI 53056-0012 | 2012-06-19 |
| 1366732752 | Ezzideen Barjes Alrawi | Internal Medicine | 111 Ann St, Waukesha, WI 53188-2263 | 2011-04-19 |
| 1063730042 | Bradley C Heraly | Internal Medicine | 1726 Shawano Avenue, Green Bay Oncology, Green Bay, WI 54303 | 2010-05-14 |
| 1528276417 | Kelly Jo Cooke | Internal Medicine | 721 American Ave Ste 508, Prohealth Care Medical Associates Inc., Waukesha, WI 53188-5071 | 2007-05-21 |
| 1205044773 | Derek Steven Serna | Internal Medicine | 1683 Whistling Hill Cir, Hartland, WI 53029 | 2007-05-18 |
| 1770706624 | Fox Valley Hematology & Oncology, S.c. | Internal Medicine | N3063 Cty Qq, Waupaca, WI 54981-9796 | 2007-04-10 |
| 1003039959 | Fox Valley Hematology & Oncology, S.c. | Internal Medicine | 1370 N Shawano St E, New London, WI 54961-2155 | 2007-04-10 |
| 1356486591 | Galen R Hasler | Internal Medicine | 350 S Hamilton St, 203, Madison, WI 53703-3861 | 2007-02-21 |
| 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.