Individual
DR. MARIANO L ROSALES JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 FERN ST, WAUPUN, WI 53963-1018
(920) 324-3559
(920) 324-0258
Mailing address
600 FERN ST, WAUPUN, WI 53963-1018
(920) 324-3559
(920) 324-0258
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
21906
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30219800
—
WI
Enumeration date
05/20/2006
Last updated
07/21/2022
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