Individual
JEFFREY C. MANLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2211 PARK AVE, MINNEAPOLIS, MN 55404-3711
(612) 871-1144
(612) 871-2012
Mailing address
2211 PARK AVE, MINNEAPOLIS, MN 55404-3711
(612) 871-1144
(612) 871-2012
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
27919
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0572003
PREFERREDONE
MN
05
—
060087300
—
MN
01
—
1000010
MEDICA PRIMARY
MN
01
—
100654
UCARE
MN
01
—
1014249
MEDICA CHOICE
MN
01
—
20938
AMERICA'S PPO
MN
01
—
31360600
MEDICAID - WISCONSIN
MN
01
—
38T54MA
BLUE SHIELD
MN
Enumeration date
08/16/2005
Last updated
07/03/2013
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