Individual
JOHN PAUL MANZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2965 BROXTON LN, YORK, PA 17402-3824
(717) 851-1405
Mailing address
2965 BROXTON LN, YORK, PA 17402-3824
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD022043E
PA
207RI0200X
Infectious Disease Physician
MD022043-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000647467
—
PA
01
—
033269
JOHNS HOPKINS
PA
01
—
093834
HIGHMARK BLUE SHIELD
PA
01
—
1523365
GATEWAY-WMG
PA
01
—
34515
GEISINGER
PA
01
—
4401108
AETNA
PA
Enumeration date
11/23/2005
Last updated
05/09/2012
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