Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mea-Aea Kenosha SC

Organization Emergency Medicine Physician · NPI 1477546737

Mea-Aea Kenosha SC is an Emergency Medicine Physician in Kenosha, Wisconsin. Registered with an NPI since 2005.

In the registry since
2005
Specialties on file
2

Practice location Address checks out

10400 75th St
Kenosha, WI 53142-7884
Phone: (262) 948-5640
Fax: (440) 842-8835
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1477546737
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Holtzclaw — President · (440) 887-4718
NPI enumeratedAugust 23, 2005
Last updated in NPPESFebruary 21, 2012
Mailing addressPo Box 637562, Mea-Aea Kenosh Sc, Cincinnati, OH 45263-0001

Other providers in Kenosha