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Contact Information

KEYVAN GHARABEIGHLOU, DO
2500 E ENTERPRISE AVE
UNIT C
APPLETON, WI54913
 Phone: 920-739-5642
 Fax: 920-968-0259
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for KEYVAN GHARABEIGHLOU · (Male)

NPI Number 1376588202
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/17/2006
Last updated 04/16/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 45650
  • WI Medicaid 43506200
Hospital affiliation(s)
  • APPLETON MED CTR - (Acute Care)
    1818 N MEADE ST
    APPLETON, WI 54911
  • BERLIN MEMORIAL HOSPITAL - (Critical Access)
    225 MEMORIAL DRIVE
    BERLIN, WI 54923
  • SHAWANO MED CTR - (Critical Access)
    309 N BARTLETTE ST
    SHAWANO, WI 54166
  • THEDA CLARK MED CTR - (Acute Care)
    130 2ND ST
    NEENAH, WI 54956
  • WILD ROSE COM MEMORIAL HOSPITAL INC - (Critical Access)
    601 GROVE AVE
    WILD ROSE, WI 54984
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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