Individual
ELWYN C MANTEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3123 SHORE DR, STE 102, MARINETTE, WI 54143-4287
(715) 732-2299
(715) 732-2419
Mailing address
3123 SHORE DR, STE 102, MARINETTE, WI 54143-4287
(715) 732-2299
(715) 732-2419
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
22450020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110221390
RR-MEDICARE
WI
05
—
30265400
—
WI
05
—
N41200005
—
MI
Enumeration date
09/30/2005
Last updated
10/05/2011
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