Palencia, Mauricio E

Palencia, Mauricio E is an individual health care provider with primary practice located at 2600 Kiley Way , Plymouth WI 53073-5020. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Palencia, Mauricio E can be contacted via phone (920) 449-7000.

Contact Information

Primary practice address
2600 Kiley Way Plymouth WI 53073-5020
Phone: (920) 449-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 43429 Wisconsin
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 43429 Wisconsin

Profile Details

NPI number 1770558264
LBN Legal business name Palencia, Mauricio E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2006
Last updated Jul 21st, 2022 - about 4 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 1770558264 NPPES
Wisconsin MEDICAID 34111200
Wisconsin MEDICAID 1770558264

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