Itagaki, Michael W.
Itagaki, Michael W. is an individual health care provider with primary practice located at 2845 Greenbrier Rd , Green Bay WI 54311-6519. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Itagaki, Michael W. can be contacted via phone (920) 288-4848.Contact Information
Primary practice address
2845 Greenbrier Rd
Green Bay WI 54311-6519
Phone: (920) 288-4848
Fax: (920) 288-4956
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 81016-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | A99197 | California |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD60125332 | Washington |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | MD60125332 | Washington |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 81016 | Wisconsin |
Profile Details
| NPI number | 1902058555 |
|---|---|
| LBN Legal business name | Itagaki, Michael W. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 15th, 2008 |
| Last updated | Aug 6th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902058555 | NPPES |
| Washington | Other | 314444 | LNI PROVIDER ID |
| Washington | MEDICAID | 100212024 | LNI PROVIDER ID |
| Washington | MEDICAID | 2023112 | LNI PROVIDER ID |
| Washington | MEDICAID | 685050 | LNI PROVIDER ID |
| Washington | Other | 305309 | LNI PROVIDER ID |
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