Individual
MANUCHER MEHRAEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
612 N 11TH ST, QUINCY, IL 62301-2662
(217) 224-9484
(217) 224-7894
Mailing address
612 N 11TH ST, QUINCY, IL 62301-2662
(217) 224-9484
(217) 224-7894
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125-060607
IL
Other
Enumeration date
07/05/2011
Last updated
07/05/2011
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