Individual
DR. PHILIP M MANZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1917 S CRISMON RD, MESA, AZ 85209-6216
(806) 107-1004
Mailing address
1917 S CRISMON RD, MESA, AZ 85209-6216
(623) 480-7100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
67232
AZ
207Q00000X
Family Medicine Physician
MD2022-1994
NM
207Q00000X
Family Medicine Physician
RS2019-0439
NM
Other
Enumeration date
06/06/2019
Last updated
09/23/2024
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