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Individual

MANU LONIAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1741 MESQUITE AVE # 100, LAKE HAVASU CITY, AZ 86403-5695
(928) 782-7972
(928) 329-4522
Mailing address
1741 MESQUITE AVE # 100, LAKE HAVASU CITY, AZ 86403-5695
(928) 782-7972
(928) 329-4522

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036113596
IL
207Q00000X
Family Medicine Physician
Primary
43225
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
579940
AZ
Enumeration date
02/09/2007
Last updated
05/01/2017
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