Individual
MR. MICHAEL W MINEHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Mailing address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
054040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130123001
UHC MA DIAMOND PROV #
WI
05
—
44352600
—
WI
01
—
54040
STATE LICENSE #
WI
01
—
P00141683
NETWORK HEALTH PROV #
WI
Enumeration date
05/31/2006
Last updated
06/22/2018
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