Mangold, Michael Norbert

Mangold, Michael Norbert is an individual health care provider with primary practice located at 120 N Main St #120, West Bend WI 53095-3376. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Mangold, Michael Norbert can be contacted via phone (262) 338-8100.

Contact Information

Primary practice address
120 N Main St #120 West Bend WI 53095-3376
Phone: (262) 338-8100
Fax: (262) 338-0405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 32859 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 32859-20 Wisconsin

Profile Details

NPI number 1588685895
LBN Legal business name Mangold, Michael Norbert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Sep 2nd, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588685895 NPPES
Wisconsin MEDICAID 31843700
Wisconsin Other 000054100
Wisconsin Other 521833

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