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Individual
PHILIP C MANTOR
Active
Individual
PHILIP C MANTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
16328
OK
2086S0102X
Surgical Critical Care Physician
16328
OK
2086S0120X
Pediatric Surgery Physician
Primary
16328
OK
Other
Enumeration date
03/14/2006
Last updated
09/05/2014
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