Individual
MICHAEL R MAGOLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
421 CAMELOT DR, FOND DU LAC, WI 54935-8335
(920) 926-8616
(920) 926-8098
Mailing address
1808 W BELTLINE HWY, SSM HEALTH FDLREGIONAL CLINIC ATTN: NANCY PIERCE, MADISON, WI 53713-2334
(920) 926-8343
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35-071501
OH
207X00000X
Orthopaedic Surgery Physician
Primary
82106-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2187002
—
OH
Enumeration date
09/27/2006
Last updated
07/13/2023
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