Provider Demographics
NPI:1346506409
Name:CASEY, MICHAEL ANTHONY (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:CASEY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:9555 76TH ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1984
Mailing Address - Country:US
Mailing Address - Phone:262-577-8000
Mailing Address - Fax:262-577-8869
Practice Address - Street 1:9555 76TH ST
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-1984
Practice Address - Country:US
Practice Address - Phone:262-577-8000
Practice Address - Fax:262-577-8869
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036140434207T00000X
PAFC8081642207T00000X
PAOS020618207T00000X
WI3100207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1346506409Medicaid