Individual
MANAL NICOLAS-JILWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
LEE ST FL 1, CHARLOTTESVILLE, VA 22908-0001
(434) 243-9312
(434) 982-5753
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
(434) 972-4266
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
0109542066
VA
2085P0229X
Pediatric Radiology Physician
MT190707
PA
Other
Enumeration date
08/20/2007
Last updated
07/23/2009
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