Manabat, Mia L
Manabat, Mia L is an sole proprietor health care provider with primary practice located at 2424 S 90Th St Ste 300 , West Allis WI 53227. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Manabat, Mia L can be contacted via phone (414) 328-8750.Contact Information
Primary practice address
2424 S 90Th St Ste 300
West Allis WI 53227
Phone: (414) 328-8750
Fax: (586) 582-6631
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 69852-21 | Wisconsin |
Profile Details
| NPI number | 1336408905 |
|---|---|
| LBN Legal business name | Manabat, Mia L |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 16th, 2012 |
| Last updated | Nov 24th, 2021 - about 3 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 | 1336408905 | NPPES |
| Wisconsin | MEDICAID | 100080507 |
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