| Ifeanyi Jeffrey Mbah, MD | |
|
820 Arbutus Ave Ste 102, Oconto, WI 54153-2004 | |
| (920) 834-8833 | |
| Not Available |
| Full Name | Ifeanyi Jeffrey Mbah |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 820 Arbutus Ave Ste 102, Oconto, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689201832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 76210-20 (Wisconsin) | Primary |
| Entity Name | Bellin Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609838473 PECOS PAC ID: 8820900749 Enrollment ID: O20031121000089 |
| Entity Name | Bellin Psychiatric Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952554800 PECOS PAC ID: 4486551058 Enrollment ID: O20031212000884 |
| Entity Name | Oconto Hospital & Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356373302 PECOS PAC ID: 2163461781 Enrollment ID: O20050713000836 |
| Mailing Address | Practice Location Address |
|---|---|
| Ifeanyi Jeffrey Mbah, MD 2851 University Ave, Green Bay, WI 54311-5855 Ph: (920) 431-2642 | Ifeanyi Jeffrey Mbah, MD 820 Arbutus Ave Ste 102, Oconto, WI 54153-2004 Ph: (920) 834-8833 |
Mrs. Norma Picio Cruz, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 501 Park Ave, Oconto, WI 54153 Phone: 920-834-7000 Fax: 920-834-6889 |