Provider Demographics
NPI:1750473013
Name:MCAULIFFE, JANET SUSAN MCCARTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:SUSAN MCCARTHY
Last Name:MCAULIFFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JANET
Other - Middle Name:SUSAN
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:W305N2593 RAVINE CT
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-4734
Mailing Address - Country:US
Mailing Address - Phone:262-367-0274
Mailing Address - Fax:
Practice Address - Street 1:W305N2593 RAVINE CT
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-4734
Practice Address - Country:US
Practice Address - Phone:262-367-0274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32213208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E97053Medicare UPIN