# WELLIFYCARE MEDICAL S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629914155
- **Authorized official:** DR. DEREJE TEFERA SIYUM MD (PRESIDENT)
- **Authorized official phone:** (262) 261-8880

## Contact information

- **Practice address:** 18200 W CAPITOL DR STE 200, BROOKFIELD, WI 53045-1446
- **Practice address phone:** (262) 261-8880
- **Mailing address:** W193N4932 TEA TREE DR, MENOMONEE FALLS, WI 53051-1644
- **Mailing address phone:** (262) 261-8880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QB0505X | Diabetology (Internal Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | — | — |
| 207RH0005X | Hypertension Specialist Physician | — | NULL | — |
| 207RH0005X | Hypertension Specialist Physician | — | — | — |
| 207RP1002X | Physician Nutrition Specialist (Internal Medicine) | — | — | — |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | — | — |
| 2083C0008X | Clinical Informatics Physician | — | NULL | — |
| 2083C0008X | Clinical Informatics Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | — | — |

## Other

- **Enumeration date:** 04/27/2026
- **Last updated:** 10/06/2026