Kenneth B Desantes, MD | |
3906 Caribou Rd, Verona, WI 53593-8407 | |
(608) 886-7300 | |
Not Available |
Full Name | Kenneth B Desantes |
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Gender | Male |
Speciality | Pediatrics - Pediatric Hematology-oncology |
Location | 3906 Caribou Rd, Verona, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1427027317 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0207X | Pediatrics - Pediatric Hematology-oncology | 40484 (Wisconsin) | Primary |
Entity Name | Aurora Medical Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Entity Name | University Of Wisconsin Medical Foundation Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598784555 PECOS PAC ID: 6608785464 Enrollment ID: O20031111000435 |
Mailing Address | Practice Location Address |
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Kenneth B Desantes, MD 3906 Caribou Rd, Verona, WI 53593-8407 Ph: (608) 886-7300 | Kenneth B Desantes, MD 3906 Caribou Rd, Verona, WI 53593-8407 Ph: (608) 886-7300 |
Kathleen A Desantes, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3906 Caribou Rd, Verona, WI 53593 Phone: 608-829-2855 | |
Mary K Schroth, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9606 Shadow Wood Dr, Verona, WI 53593 Phone: 608-219-8914 | |
Samantha N Cordum, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 301 Cross Oak Dr Unit 5, Verona, WI 53593 Phone: 208-608-4299 |