Individual
DR. MANUEL J DATILES IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5963 EXCHANGE DR STE 100, ELDERSBURG, MD 21784-9256
(410) 549-0900
(410) 549-6121
Mailing address
5963 EXCHANGE DR STE 100, ELDERSBURG, MD 21784-9256
(410) 549-0900
(410) 549-6121
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0079527
MD
Other
Enumeration date
04/16/2012
Last updated
01/06/2021
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