Individual
WILLARD JAMES MICHALSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
112 BEECH STREET, MANKATO, MN 56001
(507) 625-1589
Mailing address
112 BEECH STREET, MANKATO, MN 56001
(507) 625-1589
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
22210
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040008067
RR MEDICARE
—
01
—
1001399
MEDICA
MN
01
—
115547
UCARE
MN
01
—
410849339 56001 C047
CHAMPUS
—
01
—
41461MI
BCBS
MN
05
—
555882400
—
MN
01
—
767278
AMERICAS PPO
MN
01
—
928655
MEDICAID
IA
01
—
HP25854
HEALTH PARTNERS
MN
01
—
NA2951023845
PREFERRED ONE
MN
Enumeration date
01/13/2006
Last updated
07/30/2009
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