Mahan, Michael A
Mahan, Michael A is an individual health care provider with primary practice located at 610 W Adams St , Black River Falls WI 54615-9010. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mahan, Michael A can be contacted via phone (715) 284-4311.Contact Information
Primary practice address
610 W Adams St
Black River Falls WI 54615-9010
Phone: (715) 284-4311
Fax: (715) 284-2568
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 29474 | Wisconsin |
Profile Details
| NPI number | 1922038892 |
|---|---|
| LBN Legal business name | Mahan, Michael A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2006 |
| Last updated | Feb 15th, 2010 - about 14 years ago |
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 | 1922038892 | NPPES |
| Wisconsin | MEDICAID | 31555800 |
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