Mankiewicz, Thomas J

Mankiewicz, Thomas J is an individual health care provider with primary practice located at 3610 Michelle Witmer Memorial Drive , New Berlin WI 53151-5292. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mankiewicz, Thomas J can be contacted via phone (262) 785-1366.

Contact Information

Primary practice address
3610 Michelle Witmer Memorial Drive New Berlin WI 53151-5292
Phone: (262) 785-1366
Fax: (262) 785-1383
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22449 Wisconsin

Profile Details

NPI number 1730186511
LBN Legal business name Mankiewicz, Thomas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Sep 26th, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730186511 NPPES
Wisconsin MEDICAID 30373500

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