Individual
NICOLE E MUBANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209
(414) 352-3100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
63433-20
WI
207Q00000X
Family Medicine Physician
Primary
63433
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285976563
—
WI
Enumeration date
03/25/2013
Last updated
10/07/2025
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