Individual
MANI MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BLVD - K9, DETROIT, MI 48202
(313) 916-2066
(313) 916-2086
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BLVD - K9, DETROIT, MI 48202
(313) 916-2066
(313) 916-2086
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
071161
MI
208800000X
Urology Physician
Primary
23293101
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
338423410
—
MI
01
—
3408257931
BLUE CROSS-BLUE CROSS
—
01
—
MM071161
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/11/2006
Last updated
06/16/2021
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