Provider Demographics
NPI:1477504884
Name:CHRISTIANS, KATHLEEN K (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:K
Last Name:CHRISTIANS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:GENERAL SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-9720
Mailing Address - Fax:414-805-5934
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:GENERAL SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-9720
Practice Address - Fax:414-805-5934
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI35547208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
003000215XOtherHUMANA
WI1477504884Medicaid
G92782Medicare UPIN
WI1477504884Medicaid
WI68086 1181Medicare PIN