Provider Demographics
NPI:1144596545
Name:HOLTROP SHEETS, MAYA FRANCES (MD)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:FRANCES
Last Name:HOLTROP SHEETS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:FRANCES
Other - Last Name:SHEETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9000 W WISCONSIN AVE # MS 958
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-7615
Mailing Address - Fax:414-266-6238
Practice Address - Street 1:611 VETERANS AVE UNIT 106
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-2559
Practice Address - Country:US
Practice Address - Phone:262-353-4460
Practice Address - Fax:262-353-4461
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI62288-20208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1144596545Medicaid