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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RA0201X |
Internal Medicine Specialization: Allergy & Immunology |
14469 | WI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | MEDICARE NUMBER | 0001-68805 | 01 |
Street Address |
403 N GRAND AVE |
City | WAUKESHA |
State | WI |
Zip Code | 53186-4913 |
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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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 Code | 207RA0201X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Allergy & Immunology |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770885220 | Serenity Health Care Center Sc | Internal Medicine | 2607 N Grandview Blvd, Waukesha, WI 53188-1686 | 2010-12-03 |
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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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.