Individual
DR. EDAKANDYIL MANOHARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1980 HOLTON AVE E, SUITE 301, BIG STONE GAP, VA 24219-3366
(276) 523-0390
(276) 523-5514
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
VA01011022988
VA
Other
Enumeration date
07/29/2006
Last updated
03/10/2008
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