MR. PATRICK C. MANNEBACH (NPI# 1801971221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801971221 |
| Entity Type | Individual |
| Full Name | MR. PATRICK C. MANNEBACH |
| Credential | MD |
| Practice Address |
5045 W Grande Market Dr Appleton WI 54913-8517 |
| Mailing Address |
Bin 88040 Milwaukee WI 53288-8040 |
| Practice Telephone | 9208869380 |
| Practice Fax Number | 9208869381 |
| Mailing Telephone | 9208869380 |
| Mailing Fax Number | 9308869381 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 44202-020 | WI | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
44202-020 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
5045 W GRANDE MARKET DR |
| City | APPLETON |
| State | WI |
| Zip Code | 54913-8517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831176338 | Thomas M Tamlyn | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2005-12-27 |
| 1053884478 | Heart and Vascular of Wisconsin, Sc | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2019-01-08 |
| 1467980540 | Erin Marie Diedrick | Physician Assistant | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2017-06-01 |
| 1689626632 | Simon Edwin Roselaar | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2006-05-17 |
| 1104878149 | Douglas William Mielke | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2006-05-17 |
| 1386696987 | Glenn Richard Huth | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913 | 2006-05-16 |
| 1740231844 | William Ogden Fletcher Jr. | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2006-05-13 |
| 1649220229 | Dionisio James Mariano | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2006-05-12 |
| 1710937115 | Peter Hummel Ackell | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2006-05-10 |
| 1396703732 | Carrie B. Chapman | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2006-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
| 1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
| 1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
| 1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
| 1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
| 1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
| 1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
| 1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
| 1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
| 1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
| Find all providers in zip 54913 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1548582547 | Moe Zafarani | Internal Medicine | 3215 W Lawrence St Ste 3, Appleton, WI 54914-4274 | 2010-02-18 |
| 1831176338 | Thomas M Tamlyn | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2005-12-27 |
| 1053884478 | Heart and Vascular of Wisconsin, Sc | Internal Medicine | 5045 W Grande Market Dr, Appleton, WI 54913-8517 | 2019-01-08 |
| 1518275718 | Agei Oben Enoh | Internal Medicine | 1506 S Oneida St, Appleton, WI 54915-1305 | 2010-09-22 |
| 1346404076 | Babar Parvez | Internal Medicine | 1818 N Meade St, Appleton, WI 54911-3454 | 2008-07-11 |
| 1255522801 | Simone A Fearon | Internal Medicine | 1818 N Meade St, Appleton, WI 54911 | 2007-08-08 |
| 1689774515 | Ramamohan V Turlapati | Internal Medicine | 820 E Grant Street, Appleton, WI 54911 | 2006-09-22 |
| 1265427496 | Patrick D Obrien | Internal Medicine | 1506 S Oneida St, Appleton, WI 54915-1305 | 2005-09-14 |
| 1992790471 | Fredric L Hildebrand Jr. | Internal Medicine | 1506 S Oneida St, Appleton, WI 54915-1305 | 2005-09-12 |
| 1447245964 | Patrick B Gregory | Internal Medicine | 1506 S Oneida St, Appleton, WI 54915-1305 | 2005-09-12 |
| Find all providers in APPLETON | ||||
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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.