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Individual
MANEESH SURESH PENKAR
Active
Individual
MANEESH SURESH PENKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2013-01695
NC
207R00000X
Internal Medicine Physician
Primary
C167686
CA
207R00000X
Internal Medicine Physician
LL32972
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639480247
—
NC
05
—
NC1887
—
SC
Enumeration date
06/29/2010
Last updated
05/27/2021
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