Individual
SAMUEL D MANALO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5260
Mailing address
7 W SQUARE LAKE RD, BLOOMFIELD HILLS, MI 48302-0462
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301060591
MI
Other
Enumeration date
05/28/2006
Last updated
07/08/2007
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