Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2172 | AK |
Y | 208600000X | Surgeon | 2172 | AK |
NPI | 1003831488 |
---|---|
Provider Name | Michael D Manuel |
First Address | Anchorage, AK 99508-2978 |
Second Address | Anchorage, AK 99508-2978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D43374 | (02) | AK |