Individual
MANUEL IRIONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18 OLD ETNA RD, LEBANON, NH 03766-1937
(603) 650-3100
Mailing address
18 OLD ETNA RD, LEBANON, NH 03766-1937
(603) 650-3100
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
ME51234
FL
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
20971
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04074
BC/BS
FL
05
—
270079400
—
FL
Enumeration date
10/17/2006
Last updated
01/14/2021
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