Individual
DR. DAVID KING MIKOLYZK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 320-5251
(920) 682-2006
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7238
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036117670
IL
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
53986
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ABOSMOC
AMERICAN BOARD OF ORTHOPAEDIC SURGERY/HAND SURGERY
—
Enumeration date
07/07/2008
Last updated
03/25/2020
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