Individual
JUAN CARLOS MANIVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 DELAWARE ST SE, 760 MAYO BLDG, MINNEAPOLIS, MN 55455-0341
(612) 626-0622
Mailing address
420 DELAWARE ST SE, MMC 609, MINNEAPOLIS, MN 55455-0341
(612) 626-0622
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
29459
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0039975
—
MT
05
—
0515908
—
IA
01
—
1009228
PREFERRED ONE NUMBER
MN
01
—
101364
UCARE NO.
MN
01
—
1122550
MEDICA CHOICE NUMBER
MN
01
—
1174545
MEDICA DUAL SOLUTIONS NO.
MN
01
—
2T224MA
BCBS MN NUMBER
MN
05
—
32455000
—
WI
05
—
719205300
—
MN
01
—
768244
AMERICA'S PPO NUMBER
MN
01
—
HP22293
HEALTHPARTNERS NUMBER
MN
Enumeration date
10/26/2006
Last updated
07/09/2007
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