Individual
DR. MANIVANH KEOBOUNNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4755 OGLETOWN-STANTON ROAD, NEWARK, DE 19718
(302) 733-1000
Mailing address
2 READS WAY, SUITE 201, NEW CASTLE, DE 19720-1630
(302) 709-4510
(302) 356-9304
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C1-0009086
DE
207L00000X
Anesthesiology Physician
MT185941
PA
Other
Enumeration date
12/14/2006
Last updated
05/10/2016
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