Individual
MANOHARAN W EUSTACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1032 N IRISH RD, DAVISON, MI 48423-2209
(810) 658-2131
(810) 658-3500
Mailing address
1032 N IRISH RD, DAVISON, MI 48423-2209
(810) 658-2131
(810) 658-3500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME056842
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0250037
BLUE CARE NETWORK
MI
01
—
110250037
BCBS M
MI
01
—
3E22022
HEALTH PLUS
MI
05
—
4203754
—
MI
01
—
C3246
M CARE
MI
Enumeration date
03/23/2006
Last updated
11/11/2009
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