Individual
STEPHEN MANNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2700 FARMINGTON AVE STE 1, FARMINGTON, NM 87401-4559
(505) 609-6830
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
33150
OK
208800000X
Urology Physician
DR.0069193
CO
208800000X
Urology Physician
Primary
MD2022-1153
NM
Other
Enumeration date
06/15/2017
Last updated
11/08/2024
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