Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 772025 | WI |
N | 222Z00000X | Podiatrist | 772025 | WI |
Y | 213ES0103X | Foot & Ankle Surgery | 772 | WI |
NPI | 1023112588 |
---|---|
Provider Name | Dr. Michael Aaron Engel |
First Address | Kenosha, WI 53142-7845 |
Second Address | Kenosha, WI 53142-7845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 18/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43226500 | (05) | WI |
480028300 | RAIL RAOD MEDICARE GROUP MEMBER PTAN # (01) | WI |
U71150 | (02) |