Active NPI
Doha Itani
- Anatomic Pathology & Clinical Pathology Physician
- Milwaukee, WI
National Provider Identifier
1447443981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 72165
- Practice address
- 9200 W Wisconsin Ave
Milwaukee, WI 53226-3522 - Phone
- (414) 805-6966
- Fax
- (414) 805-6980
- NPI assigned
- Aug 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 72165 | WI | Primary |
Addresses
Primary practice location
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Mailing address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6966
Other practice location 1
3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300
Other practice location 2
W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72165 | WI | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586476800000",
"number": "1447443981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-6966",
"fax_number": "414-805-6980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-6966",
"fax_number": "414-805-6980"
}
],
"practiceLocations": [
{
"address_1": "3200 Pleasant Valley Rd",
"address_purpose": "LOCATION",
"city": "West Bend",
"state": "WI",
"postal_code": "530959274",
"country_code": "US",
"telephone_number": "262-836-7300",
"fax_number": "262-836-7301",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "W180N8085 Town Hall Rd",
"address_purpose": "LOCATION",
"city": "Menomonee Falls",
"state": "WI",
"postal_code": "530513518",
"country_code": "US",
"telephone_number": "262-251-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ITANI",
"first_name": "DOHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-18",
"last_updated": "2020-04-10",
"certification_date": "2020-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "WI",
"license": "72165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.