Provider Demographics
NPI:1760241996
Name:MW ONCOLOGY PLLC
Entity Type:Organization
Organization Name:MW ONCOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIHAILO
Authorized Official - Middle Name:
Authorized Official - Last Name:LALICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-341-6958
Mailing Address - Street 1:516 BROADWAY ST S
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-5141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:516 BROADWAY ST S
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5141
Practice Address - Country:US
Practice Address - Phone:218-341-6958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center