Individual
LUIS E MANYARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5529 HOHMAN AVE, HAMMOND, IN 46320-1936
(219) 853-7100
(219) 937-5958
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01057087A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200414420A
—
IN
Enumeration date
03/07/2006
Last updated
10/11/2023
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