Individual
MANOLIS KYRIACOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
131 KERCHEVAL AVE, GROSSE POINTE FARMS, MI 48236-3629
(313) 343-6139
Mailing address
12730 NEW BRITTANY BLVD STE 602, FORT MYERS, FL 33907-4690
(239) 275-5522
(239) 275-4464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301083718
MI
207Q00000X
Family Medicine Physician
ME132454
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5363583
—
MI
Enumeration date
05/14/2007
Last updated
11/23/2020
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