Individual
RAJ MANICKAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 SWEET PEA PATH, CROWNSVILLE, MD 21032-2020
(410) 987-7375
Mailing address
1350 SWEET PEA PATH, CROWNSVILLE, MD 21032-2020
(410) 987-7375
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0018398
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
960281000
—
MD
Enumeration date
07/03/2006
Last updated
03/18/2013
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