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General NPI Number Information
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NPI Number | 1194036533
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Entity Type | Individual
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Provider Name | JOHN MIHAILIDIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 130 2ND ST
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City | NEENAH
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State | WI
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Zip | 54956-2883
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Country | US
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Telephone | 920-358-1223
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Fax |
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Provider Business Mailing Address
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Address Line | 3 NEENAH CTR
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City | NEENAH
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State | WI
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Zip | 54956-3070
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Country | US
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Telephone | 920-358-1223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 30557
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 311791
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 84089
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License Number State | WI
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