Powell, Mario R
Powell, Mario R is an sole proprietor health care provider with primary practice located at 975 Port Washington Rd Division Of Neonatology, Grafton WI 53024-9201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Powell, Mario R can be contacted via phone (262) 329-1000.Contact Information
Primary practice address
975 Port Washington Rd Division Of Neonatology
Grafton WI 53024-9201
Phone: (262) 329-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 46494 | Wisconsin |
Profile Details
| NPI number | 1609828391 |
|---|---|
| LBN Legal business name | Powell, Mario R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2006 |
| Last updated | Sep 17th, 2019 - about 6 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 | 1609828391 | NPPES |
| Other | 008906261V | HUMANA | |
| MEDICAID | 1609828391 | HUMANA |
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