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Individual
VICKI MANZANO
Active
Individual
VICKI MANZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101008025
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100575
PHYSICIANS HEALTH PLAN
MI
01
—
202330
HEALTH ADVANTAGE
MI
05
—
3424975
—
MI
01
—
5768069
AETNA
MI
01
—
E50170
HEALTH NET FEDERAL SERVIC
MI
Enumeration date
01/09/2006
Last updated
03/17/2008
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