Individual
ALEX MANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
424 W STATE HIGHWAY 5, WACONIA, MN 55387-1795
(952) 442-4461
(952) 442-1547
Mailing address
424 W STATE HIGHWAY 5, WACONIA, MN 55387-1795
(952) 442-4461
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.081574
IL
207Q00000X
Family Medicine Physician
Primary
81984
MN
390200000X
Student in an Organized Health Care Education/Training Program
125.081574
IL
Other
Enumeration date
05/18/2023
Last updated
05/02/2026
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