Individual
DR. PAUL L MANTERNACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 4TH ST SW, MASON CITY, IA 50401-2800
(641) 428-7234
(641) 428-6373
Mailing address
621 S ILLINOIS AVE, SUITE 103, MASON CITY, IA 50401-5489
(641) 428-3041
(641) 428-3059
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
29993
IA
207Q00000X
Family Medicine Physician
29993
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5100529
—
IA
Enumeration date
12/15/2005
Last updated
07/14/2020
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