Individual
DR. MANISH KANUKUNTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10624 S EASTERN AVE # A-955, HENDERSON, NV 89052-2982
(702) 800-5393
(702) 407-7016
Mailing address
10624 S EASTERN AVE # A-955, HENDERSON, NV 89052-2982
(702) 800-5393
(702) 407-7016
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25329
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629655113
—
NV
Enumeration date
03/29/2021
Last updated
06/24/2024
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