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Individual

MINA MECHEAL BENJAMIN MEHANNI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MS

Contact information

Practice address
9200 W WISCONSIN AVE FL 4, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Mailing address
PO BOX 959354, SAINT LOUIS, MO 63195-9354
(636) 916-7272
(636) 916-7274

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036152915
IL
207R00000X
Internal Medicine Physician
62448
WI
207R00000X
Internal Medicine Physician
BP10040686
TX
207RC0000X
Cardiovascular Disease Physician
Primary
2022045774
MO
2085U0001X
Diagnostic Ultrasound Physician
036152915
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1902186166
WI
Enumeration date
08/19/2011
Last updated
05/01/2025
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