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Individual

MANOHER BEARELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
141 COMMUNICATION DR, HANNIBAL, MO 63401-3670
(573) 603-1460
(573) 603-1462
Mailing address
900 E LAHARPE ST, KIRKSVILLE, MO 63501-4520
(660) 665-1962
(660) 665-3989

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
036058614
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2011033071
MO

Other

Enumeration date
11/07/2006
Last updated
02/29/2016
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