DR. KALLURU VIJAYABHANU (NPI# 1144310475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144310475 |
| Entity Type | Individual |
| Full Name | DR. KALLURU VIJAYABHANU |
| Other Name | MANIKONDA VIJAYARHANU |
| Credential | MD |
| Practice Address |
5228 W Fond Du Lac Ave Milwaukee WI 53216 |
| Mailing Address |
8520 N Greenvale Rd Bayside WI 53217 |
| Practice Telephone | 4145362100 |
| Practice Fax Number | 4145362311 |
| Mailing Telephone | 4142289446 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
37250 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
5228 W FOND DU LAC AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417985482 | Andrew Dror Rosenbach | Psychiatry & Neurology | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2006-06-29 |
| 1689194490 | Caretox Labs Inc | Clinical Medical Laboratory | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2017-06-22 |
| 1669909412 | Jessica Mutsch | Social Worker | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2017-05-11 |
| 1003354002 | Sophia Elizabeth Prater | Counselor | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2017-02-09 |
| 1114463676 | Taylor Dwyer | Counselor | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2017-01-09 |
| 1902349905 | Glenda Nell Barber | Student in an Organized Health Care Education/Training Program | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2016-11-22 |
| 1700336419 | Achievement Associates Group Inc | Community/Behavioral Health | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2016-10-05 |
| 1497208144 | Caitlin Busha | Counselor | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2016-07-29 |
| 1386090777 | Jenna Emanuele | Counselor | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216 | 2016-05-04 |
| 1043685712 | Courtney Stack | Student in an Organized Health Care Education/Training Program | 5228 W Fond Du Lac Ave, Milwaukee, WI 53216-1346 | 2015-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750906137 | Lilshana Woods | Technician | 3946 N 52nd St, Milwaukee, WI 53216 | 2020-06-11 |
| 1063981710 | Jon Maurice Smoots | Prevention Professional | 7710 W. Casper Street, Milwaukee, WI 53216 | 2018-11-23 |
| 1467948844 | Alexcis Coleman | Counselor | 6815 W Capitol Dr Ste 217, Milwaukee, WI 53216 | 2018-07-09 |
| 1457841066 | Rebeka Fried | Occupational Therapist | 3134 N 53rd St, Milwaukee, WI 53216 | 2018-05-18 |
| 1952831497 | Nina Marie Evans | Home Health Aide | 6815 W. Capitol Drive Suite 117, Milwaukee, WI 53216 | 2017-06-18 |
| 1578009080 | Annette L Veasey | Counselor | 4222 W Capitol Dr Ste 308, Milwaukee, WI 53216 | 2017-01-09 |
| 1295277143 | Gentle Hands Home Healthcare | Home Health | 6815 N. 68th Street, Milwaukee, WI 53216 | 2016-11-09 |
| 1639622780 | Luisa Julia Morales | Counselor | 5228 Fond Du Lac Ave, Milwaukee, WI 53216 | 2016-07-25 |
| 1568811776 | Eye-care Home Health Care | In Home Supportive Care | 6221 W Keefe Pkwy, Milwaukee, WI 53216 | 2016-06-08 |
| 1013382167 | Helens Supportive Services | Home Health | 6222 W Capitol Drive Sutie 200c, Milwaukee, WI 53216 | 2015-12-01 |
| Find all providers in zip 53216 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1003882994 | Soryal A Soryal | Internal Medicine | 1020 N 12th St, 3rd Floor, Milwaukee, WI 53233-1308 | 2006-02-28 |
| 1720407893 | Cara Coughlin O'brien | Internal Medicine | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2014-04-15 |
| 1063839397 | Elizabeth Ann Bukowy | Internal Medicine | 9200 W Wisconsin Ave, Specialty Clinics Building, 4th Floor, Milwaukee, WI 53226-3522 | 2014-03-25 |
| 1275890568 | Laura Ann Previll | Internal Medicine | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2012-04-12 |
| 1518261510 | Zaw Moe Aung | Internal Medicine | 8520 W Oklahoma Ave, Milwaukee, WI 53227-4604 | 2011-01-05 |
| 1972762979 | Alina M Petculescu | Internal Medicine | 8520 W Oklahoma Ave, Milwaukee, WI 53227-4604 | 2008-06-04 |
| 1053469536 | Michael L Malone | Internal Medicine | 1020 N 12th St, 3rd Floor, Milwaukee, WI 53233-1308 | 2007-01-08 |
| 1205991254 | Tyler H Steward | Internal Medicine | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2006-12-27 |
| 1861582215 | Marilyn J Sincaban | Internal Medicine | 1555 S Layton Blvd, Milwaukee, WI 53215-1924 | 2006-10-14 |
| 1154421865 | Richard P Thiede | Internal Medicine | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2006-09-23 |
| 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.