Mammen, Aykarethu O
Mammen, Aykarethu O is an individual health care provider with primary practice located at 4922 Columbia Rd , Cedarburg WI 53012-9188. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mammen, Aykarethu O can be contacted via phone (262) 375-2829.Contact Information
Primary practice address
4922 Columbia Rd
Cedarburg WI 53012-9188
Phone: (262) 375-2829
Fax: (262) 375-8513
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 20052 | Wisconsin |
Profile Details
| NPI number | 1417993791 |
|---|---|
| LBN Legal business name | Mammen, Aykarethu O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
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 | 1417993791 | NPPES |
| Wisconsin | MEDICAID | 31155700 |
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