Mielke, Michelle M

Mielke, Michelle M is an individual health care provider with primary practice located at 915 Summit Ave , Oconomowoc WI 53066-3994. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mielke, Michelle M can be contacted via phone (262) 569-2300.

Contact Information

Primary practice address
915 Summit Ave Oconomowoc WI 53066-3994
Fax: (262) 569-2202
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 43366 Wisconsin

Profile Details

NPI number 1093822587
LBN Legal business name Mielke, Michelle M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Mar 7th, 2023 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093822587 NPPES
Wisconsin MEDICAID 34085900

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