| Mariano L. Rosales Jr., M.d. S.c. | |
|
600 Fern St Waupun WI 53963-1018 | |
| (920) 324-3559 | |
| (920) 324-0258 |
| Full Name | Mariano L. Rosales Jr., M.d. S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 Fern St, Waupun, Wisconsin |
| Authorized Official Name and Position | Mariano L Rosales Jr (PRESIDENT) |
| Authorized Official Contact | 9203243559 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mariano L. Rosales Jr., M.d. S.c. 600 Fern St Waupun WI 53963-1018 Ph: (920) 324-3559 | Mariano L. Rosales Jr., M.d. S.c. 600 Fern St Waupun WI 53963-1018 Ph: (920) 324-3559 |
| NPI Number | 1386832228 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 10/04/2007 |
| Medicare PECOS PAC ID | 8527049949 |
|---|---|
| Medicare Enrollment ID | O20040601000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386832228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2190120 (Wisconsin) | Secondary |
| 261Q00000X | Clinic/center | 2190620 (Wisconsin) | Primary |
| Provider Name | Mariano L Rosales |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982658118 PECOS PAC ID: 0244211662 Enrollment ID: I20040603000725 |
New Medical Center, S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 160 Gateway Dr, Ste A, Waupun, WI 53963 Phone: 920-324-9899 Fax: 920-324-9898 | |
(inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Gateway Dr, Waupun, WI 53963 Phone: 920-345-1306 Fax: 920-345-1325 |