Individual
VINCENT J MINICHIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1050 E BROADWAY, MONONA, WI 53716-4023
(608) 287-5899
(608) 251-2332
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
63222
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63222
LICENSE
WI
Enumeration date
04/19/2013
Last updated
05/16/2023
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