Individual
MANAR EDRISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 NE 13TH ST STE 1C, OKLAHOMA CITY, OK 73104-5040
(405) 271-6110
Mailing address
7350 ORCHARD AVE, DEARBORN, MI 48126-1310
(313) 663-0904
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
43054
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
03/24/2022
Last updated
09/25/2024
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