Individual
MICHAEL MCMANUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
350 W THOMAS RD, PHOENIX, AZ 85013-4409
(602) 406-8798
(602) 294-5033
Mailing address
350 W THOMAS RD, PHOENIX, AZ 85013-4409
(602) 406-8798
(602) 294-5033
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R72152
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R72152
TRAINING PERMIT
AZ
Enumeration date
06/29/2010
Last updated
06/29/2010
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