Mendoza, Manuel A

Mendoza, Manuel A is an individual health care provider with primary practice located at 1405 Mill St , New London WI 54961-2155. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Mendoza, Manuel A can be contacted via phone (920) 531-2000.

Contact Information

Primary practice address
1405 Mill St New London WI 54961-2155
Phone: (920) 531-2000
Fax: (920) 531-2030
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 387187-020 Wisconsin
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 38187 Wisconsin

Profile Details

NPI number 1740269158
LBN Legal business name Mendoza, Manuel A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated Nov 6th, 2020 - about 4 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 1740269158 NPPES
Wisconsin MEDICAID 32248400
Wisconsin Other 1009390
Wisconsin Other 70
Wisconsin Other 930117017

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