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Individual
SURJIT S MANIKTALA
Active
Individual
SURJIT S MANIKTALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
53518
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110057924A
—
MA
01
—
110211580
RAIL ROAD MEDICARE
MA
01
—
698120
HARVARD PILGRIM HEALTH CA
MA
01
—
764557
TUFTS HEALTH PLAN
MA
01
—
J13686
BC/BS
MA
Enumeration date
10/03/2006
Last updated
03/17/2018
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