Organization
MAGO MEDICAL INC
Active
Other names
Lincoln Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL GLENN OLACIREGUI M.D. (OWNER/DOCTOR)
(414) 385-9801
Entity
Organization
Contact information
Practice address
573 W LINCOLN AVE, MILWAUKEE, WI 53207-1141
(414) 385-9801
(414) 385-9803
Mailing address
PO BOX 11430, MILWAUKEE, WI 53211-0430
(414) 962-9070
(414) 962-9050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42851-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21285500
—
WI
Enumeration date
09/20/2006
Last updated
08/22/2020
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