Individual
DR. MOHAMMAD Y MANNAN
Active
Individual
DR. MOHAMMAD Y MANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38017
KY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
38017
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000334095
BLUE CROSS BLUE SHIELD
KY
01
—
000001215568
CHA PROVIDER ID
KY
01
—
0933601
MEDICARE NATIONAL GOVERNMENT SERVICES
KY
05
—
64082548
—
KY
01
—
P00197698
RAILROAD MEDICARE
KY
Enumeration date
11/01/2006
Last updated
09/19/2024
Update your record
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