Siyum, Dereje T
Siyum, Dereje T is an individual health care provider with primary practice located at 18200 W Capitol Dr Ste 200 , Brookfield WI 53045-1446. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Obesity Medicine, Allopathic & Osteopathic Physicians / Clinical Informatics. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Siyum, Dereje T can be contacted via phone (262) 261-8880.Contact Information
Primary practice address
18200 W Capitol Dr Ste 200
Brookfield WI 53045-1446
Phone: (262) 261-8880
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 74852-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 74852-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Obesity Medicine | 207RB0002X | 74852-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Clinical Informatics | 2083C0008X | 74852-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Obesity Medicine | 2083B0002X | 74852-20 | Wisconsin |
Profile Details
| NPI number | 1164981007 |
|---|---|
| LBN Legal business name | Siyum, Dereje T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2019 |
| Last updated | Oct 1st, 2026 - about last week |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164981007 | NPPES |
| Wisconsin | MEDICAID | 100202312 |
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