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Contact Information

MIA L MANABAT, DO
2424 S 90TH ST STE 300
WEST ALLIS, WI53227
 Phone: 414-328-8750
 Fax: 586-582-6631
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for MIA L MANABAT · (Female)

NPI Number 1336408905
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/16/2012
Last updated 08/15/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 69852-21
  • WI Medicaid 100080507
Hospital affiliation(s)
  • AURORA MEDICAL CENTER - (Acute Care)
    975 PORT WASHINGTON ROAD
    GRAFTON, WI 53024
  • AURORA WEST ALLIS MEDICAL CENTER - (Acute Care)
    8901 W LINCOLN AVE
    WEST ALLIS, WI 53227
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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