Individual
MR. DOUGLAS WILLIAM MIELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5045 W GRANDE MARKET DR, APPLETON, WI 54913-8517
(920) 886-9380
(920) 886-9381
Mailing address
BIN 88040, MILWAUKEE, WI 53288-0040
(920) 886-9380
(920) 886-9381
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35277-020
WI
207RC0000X
Cardiovascular Disease Physician
35277-020
WI
207RI0011X
Interventional Cardiology Physician
Primary
35277-020
WI
Other
Enumeration date
05/17/2006
Last updated
03/26/2020
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