Individual
MARIA C MANALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
540 N NELLIS BLVD, LAS VEGAS, NV 89110-5368
(702) 877-5199
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11659
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100508995
—
NV
05
—
100508996
—
NV
01
—
1730121096
SMA MEDICAID
NV
01
—
V110779
SMA MEDICARE
NV
Enumeration date
06/12/2006
Last updated
11/18/2024
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