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Individual

MR. MICHAEL W MINEHART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

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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