Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 38593 | CO |
NPI | 1013914159 |
---|---|
Provider Name | Dr. Sean P Manion |
First Address | Longmont, CO 80501-3128 |
Second Address | Longmont, CO 80501-3128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 08/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
347548 | (05) | CO |
40123588 | (05) | CO |
H14438 | (02) | CO |