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Individual

DR. WILLIAM DAVID MANAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2615 EAST FRANKLIN AVE, UFP SMILEY'S CLINIC, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55406
(612) 333-0770
Mailing address
2615 EAST FRANKLIN AVE, UFP SMILEY'S CLINIC, UNIVERSITY OF MN PHYSICIANS, MINNEAPOLIS, MN 55406
(612) 333-0770

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17751
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-09659
MEDICA CHOICE
01
1011064
PREFERRED ONE
01
114700
UCARE
05
1938175
IA
01
299J2MA
BLUE CROSS BLUE SHIELD
05
34311400
WI
01
894137
ARAZ
01
HP18753
HEALTH PARTNERS
Enumeration date
10/20/2006
Last updated
07/08/2007
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