Individual
MANUEL M BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
960 WINDHAM CT, SUITE 1, BOARDMAN, OH 44512-5087
(330) 726-3357
(330) 726-1465
Mailing address
960 WINDHAM CT STE 1, BOARDMAN, OH 44512-5087
(330) 726-3357
(330) 726-1465
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35089622
OH
207RP1001X
Pulmonary Disease Physician
Primary
35089622
OH
207RS0012X
Sleep Medicine (Internal Medicine) Physician
35089622
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2475585
—
OH
Enumeration date
01/04/2006
Last updated
11/12/2025
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