Individual
DR. SHEILAINE R MABANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
(218) 894-8767
Mailing address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
(218) 894-8767
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME74201
FL
2085R0001X
Radiation Oncology Physician
Primary
65060
MN
2085R0001X
Radiation Oncology Physician
ME74201
FL
2085R0001X
Radiation Oncology Physician
P6999
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259085900
—
FL
01
—
295100YS65
MEDICARE ID
TX
05
—
328624701
—
TX
Enumeration date
05/04/2006
Last updated
11/20/2025
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