Individual
MARY PATRICIA MCMANMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
148 W HIVELY AVE STE 1, ELKHART, IN 46517-2191
(574) 293-0052
(574) 343-1390
Mailing address
2714 S 11TH ST, SUITE A, NILES, MI 49120-4761
(269) 683-1700
(269) 683-7038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01055036A
IN
207Q00000X
Family Medicine Physician
4301079052
MI
Other
Enumeration date
07/07/2006
Last updated
02/25/2025
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