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Individual

ANDREA TERESA DIMICHELE-MANES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
310 E WALNUT ST, GARDEN CITY, KS 67846-5572
(620) 275-9752
(620) 275-4306
Mailing address
11083 W 2 1/2 MILE RD, CHUBBUCK, ID 83202-5208
(910) 639-5703

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
04-45692
KS
207V00000X
Obstetrics & Gynecology Physician
200601542
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5906092
NC
Enumeration date
09/25/2006
Last updated
05/06/2024
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