LEWIS R DOMKE (NPI# 1407865967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407865967 |
| Entity Type | Individual |
| Full Name | LEWIS R DOMKE |
| Credential | M.D. |
| Practice Address |
201 N Mayfair Rd Wauwatosa WI 53226-4216 |
| Practice Telephone | 4142561940 |
| Practice Fax Number | 4142561941 |
| Mailing Telephone | 4142561940 |
| Mailing Fax Number | 4142561941 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2010-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
46542 | WI | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
46542 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEA LICENSE | AD1169069 | 01 |
| Street Address |
201 N MAYFAIR RD |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53226-4216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710989090 | Anthony A Rieder | Otolaryngology | 201 N Mayfair Rd, Suite #515, Wauwatosa, WI 53226-4216 | 2005-06-01 |
| 1699374066 | Cassandra Leightner | Pharmacist | 201 N Mayfair Rd, Infusion Pharmacy - 1st Floor, Wauwatosa, WI 53226 | 2020-10-18 |
| 1518423995 | Ascension Se Wisconsin Hospital, Inc | Clinic/Center | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2019-02-11 |
| 1952872376 | Amanda Janczak | Physician Assistant | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-12-11 |
| 1780160929 | Chad Knutson | Health Educator | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-07-11 |
| 1518456938 | Elizabeth Charlene Morien | Dietetic Technician, Registered | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2018-05-02 |
| 1912422692 | Kayla Jankins | Physician Assistant | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2017-08-03 |
| 1093248213 | Elizabeth Arnold | Dietitian, Registered | 201 N Mayfair Rd, 2nd Fl, Wauwatosa, WI 53226-4216 | 2017-04-05 |
| 1033651062 | Alison Ward | Nurse Practitioner | 201 N Mayfair Rd, Wauwatosa, WI 53226-4216 | 2016-11-08 |
| 1619427168 | Kathleen Ann Sinclair | Nurse Practitioner | 201 N Mayfair Rd, Suite 310, Wauwatosa, WI 53226-4216 | 2016-10-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| 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 |
|---|---|---|---|---|
| 1871804757 | Dheeraj Reddy | Internal Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226 | 2010-06-25 |
| 1689860132 | Oncology Alliance, S.c. | Internal Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2007-09-19 |
| 1619944840 | Kurt Oesterling | Internal Medicine | 1055 N Mayfair Rd, Wauwatosa, WI 53226-3436 | 2006-03-07 |
| 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 |
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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.