Individual
DR. MAURICIO E PALENCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 KILEY WAY, PLYMOUTH, WI 53073-5020
(920) 449-7000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
43429
WI
207Q00000X
Family Medicine Physician
43429
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34111200
—
WI
Enumeration date
02/20/2006
Last updated
08/15/2024
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