Individual
MANUAL A. CASANOVA
Active
Individual
MANUAL A. CASANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
15247
WV
2085R0202X
Diagnostic Radiology Physician
Primary
35-04-1898
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007167
ANTHEM BCBS
—
01
—
000000193267
UNISON MEDICAID
OH
01
—
001714053
MOUNTAIN STATE BCBS
—
05
—
0118150000
—
WV
01
—
0465296
MOLINA MEDICAID
OH
01
—
300028173
RR MEDICARE
—
Enumeration date
05/17/2006
Last updated
02/11/2010
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