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Individual

PETER J MANOS

Active
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Individual

PETER J MANOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00020433
WA
208M00000X
Hospitalist Physician
MD00020433
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0163081
LABOR & INDUSTRY
WA
01
110195818
RAILROAD MEDICARE
01
805168700
IDAHO MEDICAID
WA
05
8558504
WA
01
M112
BLUE SHIELD
WA
01
MD657WA
ALASKA MEDICAID
WA
01
US0861599
AETNA/USHC SPECIALIST
WA
Enumeration date
08/04/2006
Last updated
05/05/2010
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