Sponagle, Stephen K
Sponagle, Stephen K is an individual health care provider with primary practice located at 1155 North Mayfair Road Behavioral Health Clinic @ Tosa, Milwaukee WI 53226. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Sponagle, Stephen K can be contacted via phone (414) 805-3666.Contact Information
Primary practice address
1155 North Mayfair Road Behavioral Health Clinic @ Tosa
Milwaukee WI 53226
Phone: (414) 805-3666
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 47580 | Wisconsin |
Profile Details
NPI number | 1255382925 |
---|---|
LBN Legal business name | Sponagle, Stephen K |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 15th, 2006 |
Last updated | Jul 8th, 2007 - about 17 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 | 1255382925 | NPPES |
Wisconsin | MEDICAID | 34601100 |
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