Individual
DR. JACK MANNHEIMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., P.C.
Contact information
Practice address
500 N LEWIS RUN RD STE 129, WEST MIFFLIN, PA 15122-3058
(412) 469-8220
(412) 469-9365
Mailing address
500 N LEWIS RUN RD STE 129, WEST MIFFLIN, PA 15122-3058
(412) 469-8220
(412) 469-9365
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD009462E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0553217
—
PA
01
—
803622
MEDICARE GROUP NUMBER
PA
Enumeration date
09/21/2006
Last updated
12/04/2013
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