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Individual

DR. MAUREEN A BOYLE-MANGANARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
201 RIDGE ST, STE 312, COUNCIL BLUFFS, IA 51503-4643
(712) 396-7880
(712) 396-7885
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2001005627
MO
207V00000X
Obstetrics & Gynecology Physician
28036
NE
207VX0000X
Obstetrics Physician
Primary
MD-43345
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10001545401
COMMUNITY HEALTH PLAN
05
10026211300
NE
05
10026301600
NE
05
100402030B
KS
05
1245255934
IA
01
29689029
BLUE CROSS BLUE SHIELD
MO
01
414770
FIRSTGUARD
01
44054528964506V018
TRICARE/CHAMPUS
01
465449
CHILDRENS MERCY FAMILY HEALTH
MO
05
47068731777
NE
01
476709
HEALTHLINK
01
5897653
AETNA
01
P00036242
RAILROAD MEDICARE
Enumeration date
07/13/2006
Last updated
09/07/2017
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