Individual
MARIA G FERNANDEZ MANRIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1860 SHAWANO AVE, GREEN BAY, WI 54303-2667
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
83947-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100288831
—
WI
Enumeration date
05/17/2019
Last updated
12/20/2024
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