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Individual

MANU BANSAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
911 BY PASS ROAD, PIKEVILLE, KY 41501-1689
(606) 218-1000
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 218-6280

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48158
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100366220
KY
Enumeration date
01/18/2014
Last updated
05/03/2017
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