Individual
SCOTT JOSEPH MANGO
Active
Individual
SCOTT JOSEPH MANGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704206863
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0872871
BCBSM
MI
01
—
100680
AANA
MI
01
—
P01290769
RAILROAD MEDICARE
MI
Enumeration date
09/19/2013
Last updated
04/24/2026
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