DR. WAYNE HARRY KONETZKI


Address: 403 N Grand Ave, Waukesha, WI 53186-4913
Phone: 2625473055

DR. WAYNE HARRY KONETZKI (NPI# 1285800367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285800367
Entity Type Individual
Full Name DR. WAYNE HARRY KONETZKI
Credential M.D.
Practice Address 403 N Grand Ave
Waukesha
WI 53186-4913
Practice Telephone 2625473055
Practice Fax Number 2625472129
Mailing Telephone 2625473055
Mailing Fax Number 2625472129
Enumeration Date 2008-05-07
Last Update Date 2008-05-07
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RA0201X Internal Medicine
Specialization: Allergy & Immunology
14469 WI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI MEDICARE NUMBER 0001-68805 01

Office Location

Street Address 403 N GRAND AVE
City WAUKESHA
State WI
Zip Code 53186-4913

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851300933 Glenn Toth Family Medicine 403 N Grand Ave, Waukesha, WI 53186-4913 2006-08-06
1518500776 Paige Foss Counselor 403 N Grand Ave, Waukesha, WI 53186-4984 2019-10-21
1700341542 Joshua Brunia Massage Therapist 403 N Grand Ave, Waukesha, WI 53186-4984 2019-02-06
1447726575 Richelle Mastalir Counselor 403 N Grand Ave, Waukesha, WI 53186-4913 2018-10-16
1588147573 Chanita Jedlicka Massage Therapist 403 N Grand Ave, Waukesha, WI 53186-4913 2018-09-14
1932695871 Iris Health Clinic LLC Internal Medicine 403 N Grand Ave, Waukesha, WI 53186-4913 2018-07-03
1033611850 Waukesha Community Acupuncture & Massage Massage Therapist 403 N Grand Ave, Waukesha, WI 53186-4913 2018-03-07
1942735766 Iris Health Clinic Counselor 403 N Grand Ave, Waukesha, WI 53186-4913 2017-04-30
1811351331 Blia Vang Counselor 403 N Grand Ave, Waukesha, WI 53186-4984 2016-04-11
1295980019 Waukesha Environmental Health Allergy & Immunology 403 N Grand Ave, Waukesha, WI 53186-4913 2008-11-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295391472 Christine Lowdon Triggs Dentist 21680 West Bluemound Rd, Waukesha, WI 53186 2019-05-14
1881182889 Allure Medical of Wisconsin Pllc Clinic/Center 1930 W Bluemound Rd Ste 340, Waukesha, WI 53186 2018-04-25
1316462104 Mary B Mckee Dietitian, Registered 22370 W Bluemound Rd, #102, Waukesha, WI 53186 2017-08-14
1740738343 Rebecca Menelle Physical Therapist 1809 Shepherd Ct, Apt 206, Waukesha, WI 53186 2016-09-13
1568919876 Dianne Isnard Physical Therapist W231n1440 Corporate Court, Waukesha, WI 53186 2016-09-02
1982065991 Brandon James Decker Nurse Practitioner 21775 Hillcrest Drive, Waukesha, WI 53186 2016-03-18
1598142937 Sophia Marie Klingbiel Social Worker 1515 Paramount Dr., Waukesha, WI 53186 2015-05-06
1326478165 Glen D Haberman Dentist 141 Wisconsin Avenue, Waukesha, WI 53186 2013-11-14
1487991014 Sara Nicole Francis Counselor 217 Wisconsin Ave Ste 211, Waukesha, WI 53186 2013-01-16
1770862054 Alex Colque, M.d. S.c. Plastic Surgery 21675 E Moreland Blvd, Suite 100, Waukesha, WI 53186 2011-08-04
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Taxonomy Information

Taxonomy Code 207RA0201X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Allergy & Immunology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770885220 Serenity Health Care Center Sc Internal Medicine 2607 N Grandview Blvd, Waukesha, WI 53188-1686 2010-12-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306140439 Jared I Darveaux Internal Medicine 311 Gundersen Dr, Onalaska, WI 54650 2011-01-04
1285841155 Nathan M Lebak Internal Medicine 252 Mchenry St Ste 8, Burlington, WI 53105-1828 2007-05-17
1861468712 Robert J Kriz Internal Medicine 9013 Bentley Grn, Verona, WI 53593-7858 2006-02-28
1053739714 David L Peloza Internal Medicine 1821 S Stoughton Rd, Madison, WI 53716-2257 2014-03-31
1154616795 Ashvini Varadhi Biswas Internal Medicine 10400 75th St, Kenosha, WI 53142-7884 2011-06-11
1447309786 Mark H Hermanoff Internal Medicine 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 2007-01-09
1407963457 Shelley K Watters Internal Medicine 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 2006-08-24
1073543096 Anita I Gheller-rigoni Internal Medicine 855 N Westhaven Dr, Oshkosh, WI 54904-7668 2006-07-04
1326084534 Ravi Viswanathan Internal Medicine 451 Junction Rd, Madison, WI 53717-2656 2006-06-22
1598711665 Monica Vasudev Internal Medicine 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 2006-05-26
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Competitor

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City WAUKESHA
Zip Code 53186

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Dataset Information

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.

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