Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 2003013583 | MO |
NPI | 1043227184 |
---|---|
Provider Name | Dr. Michelle Ann Manalang |
First Address | Marshfield, WI 54449-5703 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 06/04/2021 |