Maldonado, Ivan L
Maldonado, Ivan L is an individual health care provider with primary practice located at 1000 N Oak Ave , Marshfield WI 54449-5703. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Surgical Critical Care is his primary health care specialty. Maldonado, Ivan L can be contacted via phone (715) 387-5511.Contact Information
Primary practice address
1000 N Oak Ave
Marshfield WI 54449-5703
Phone: (715) 387-5511
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 55941 | Wisconsin |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 59285 | New Jersey |
Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 59285 | New Jersey |
Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | 55941 | Wisconsin |
Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | 59285 | New Jersey |
Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 55941 | Wisconsin |
Profile Details
NPI number | 1518963347 |
---|---|
LBN Legal business name | Maldonado, Ivan L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 27th, 2005 |
Last updated | Nov 17th, 2022 - about 2 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 | 1518963347 | NPPES |
Wisconsin | MEDICAID | 1518963347 |
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