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Individual

DR. WILLIAM A MANZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1111 6TH AVE, DES MOINES, IA 50314-2613
(515) 643-2667
Mailing address
1111 6TH AVE, DES MOINES, IA 50314-2613
(515) 643-2667

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036136302
IL
2085R0202X
Diagnostic Radiology Physician
113481
MO
2085R0202X
Diagnostic Radiology Physician
3605
AR
2085R0202X
Diagnostic Radiology Physician
453710
PA
2085R0202X
Diagnostic Radiology Physician
Primary
46468
IA
2085R0202X
Diagnostic Radiology Physician
G76974
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139978001
AR
01
173098
MO BLUE SHIELD
MO
05
208856120
MO
01
98374
ARK BLUE SHIELD
AR
Enumeration date
02/02/2007
Last updated
07/29/2020
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