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Individual
DR. MICHAEL NORBERT MANGOLD
Active
Individual
DR. MICHAEL NORBERT MANGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
32859
WI
207Q00000X
Family Medicine Physician
Primary
32859-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000054100
MEDICARE, WPS, FQHC
WI
05
—
31843700
—
WI
01
—
521833
MEDICARE FQHC
WI
Enumeration date
07/21/2006
Last updated
09/02/2011
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