Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 42858 | WI |
NPI | 1073510004 |
---|---|
Provider Name | Michael E Keefe |
First Address | Glendale, WI 53212-1082 |
Second Address | Milwaukee, WI 53211-4528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 11/06/2012 |