Individual
JOELLE M MENGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
94 CHRISTIANA RD, NEW CASTLE, DE 19720-3118
(302) 327-7630
(302) 327-7635
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3125
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036134016
IL
207Q00000X
Family Medicine Physician
2015-02157
NC
207Q00000X
Family Medicine Physician
39066
SC
207Q00000X
Family Medicine Physician
40773
IA
207Q00000X
Family Medicine Physician
Primary
C1-0026573
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629389184
—
NC
05
—
1932193224
—
IA
05
—
NC2691
—
SC
Enumeration date
06/29/2010
Last updated
07/15/2024
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