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General NPI Number Information
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NPI Number | 1629389184
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Entity Type | Individual
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Provider Name | JOELLE M MENGANG MD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 07/15/2024
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Provider Practice Location Address
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Address Line | 94 CHRISTIANA RD
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City | NEW CASTLE
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State | DE
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Zip | 19720-3118
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Country | US
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Telephone | 302-327-7630
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Fax | 302-327-7635
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Provider Business Mailing Address
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Address Line | 500 W RIVER DR
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City | DAVENPORT
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State | IA
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Zip | 52801-1014
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Country | US
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Telephone | 563-336-3000
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Fax | 563-336-3125
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C1-0026573
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036134016
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39066
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 40773
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2015-02157
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License Number State | NC
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