Healthcare Provider Details

I. General information

NPI: 1750899357
Provider Name (Legal Business Name): HELEN MANNING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF WISCONSIN GYNECOLOGY 600 HIGHLAND AVENUE
MADISON WI
53792-0001
US

IV. Provider business mailing address

1002 WILLOW LN
MADISON WI
53705-1137
US

V. Phone/Fax

Practice location:
  • Phone: 608-265-9510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number66710-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: