MIA L MANABAT (NPI# 1336408905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336408905 |
| Entity Type | Individual |
| Full Name | MIA L MANABAT |
| Credential | D.O. |
| Practice Address |
2424 S 90th St Ste 300 West Allis WI 53227 |
| Mailing Address |
2424 S 90th St Ste 300 West Allis WI 53227-2455 |
| Practice Telephone | 4143288750 |
| Practice Fax Number | 5865826631 |
| Mailing Telephone | 4143288750 |
| Mailing Fax Number | 5865826631 |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2019-08-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
69852-21 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100080507 | 05 |
| Street Address |
2424 S 90TH ST STE 300 |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215020326 | Richard J Grieshop | Surgery | 2424 S 90th St Ste 300, West Allis, WI 53227-2455 | 2006-10-02 |
| 1790382323 | Melissa Marie O'hanison | Nurse Practitioner | 2424 S 90th St Ste 300, West Allis, WI 53227-2455 | 2020-10-06 |
| 1023212289 | Hesham M Elghannam | Internal Medicine | 2424 S 90th St Ste 300, West Allis, WI 53227-2455 | 2007-06-12 |
| 1447343637 | John F Kispert | Surgery | 2424 S 90th St Ste 300, West Allis, WI 53227-2455 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457552689 | Erica Ann Samuel | Internal Medicine | 2424 S 90th St Ste 410, West Allis, WI 53227-2455 | 2007-05-28 |
| 1154383909 | Lane A. Kistler | Internal Medicine | 2424 S 90th St, Suite 306, West Allis, WI 53227-2455 | 2006-04-06 |
| 1215999065 | Jerome T Hanson | Internal Medicine | 2424 S 90th St, Suite 306, West Allis, WI 53227-2455 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265872998 | Eugene Kligman | Internal Medicine | 13133 N Port Washington Rd Ste G16, Mequon, WI 53097-2423 | 2013-06-26 |
| 1770929226 | Paul Michael Estrada | Internal Medicine | 437 N Frances St, Madison, WI 53703-2013 | 2013-05-10 |
| 1174851273 | Victor Ciofoaia | Internal Medicine | 700 West Ave South, La Crosse, WI 54601 | 2009-12-01 |
| 1255594537 | Freddy Caldera Jr. | Internal Medicine | 1685 Highland Avenue, 4256 Mfcb, Madison, WI 53705 | 2008-07-07 |
| 1629157425 | Charles Cromwell | Internal Medicine | 2311 N Prospect, Milwaukee, WI 53211 | 2006-11-03 |
| 1992805832 | Suhasini Turlapati | Internal Medicine | 820 E Grant Street, Appleton, WI 54911 | 2006-09-22 |
| 1679676936 | Holy Family Memorial Inc | Internal Medicine | 800 Lakefront Way, Two Rivers, WI 54241-3301 | 2006-09-05 |
| 1639287436 | Kevin A Lang | Internal Medicine | M207 Marsh Ln, Marshfield, WI 54449-9293 | 2006-08-29 |
| 1063423515 | Joel M Carlson | Internal Medicine | 420 Dewey Street, Wisconsin Rapids, WI 54495-0005 | 2006-08-10 |
| 1174538854 | Associates In Gastroenterology Sc | Internal Medicine | 2700 E Enterprise Ave, Unit C, Appleton, WI 54913-7890 | 2006-07-30 |
| Find all providers with the same taxonomy | ||||
| City | WEST ALLIS |
| Zip Code | 53227 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.