Individual
PAUL J MANKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10219 N TRILLIUM RD, MEQUON, WI 53092-6174
(262) 241-5355
(262) 241-4557
Mailing address
10219 N TRILLIUM RD, MEQUON, WI 53092-6174
(262) 241-5355
(262) 241-4557
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25349
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30662500
—
WI
Enumeration date
04/03/2006
Last updated
07/08/2007
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