MEDICARE: DR. CHRISTOPHER F MILDENBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	49841	WI
2	207R00000X	Internal Medicine Physician	1154409175	WI

General Provider Information

NPI Number	:	1154409175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER F MILDENBERG MD

Provider Business Mailing Address
First Line	:	30 N 18TH AVE STE 4B
Second Line	:
City	:	STURGEON BAY
State	:	WI
Zip	:	54235-3207
Country	:	US
Telephone Number	:	920-818-1001
Fax Number	:	833-438-1838

Provider Business Practice Location Address
First Line	:	30 N 18TH AVE STE 4B
Second Line	:
City	:	STURGEON BAY
State	:	WI
Zip	:	54235-3207
Country	:	US
Telephone Number	:	920-818-1001
Fax Number	:	833-438-1838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/28/2025

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