Individual
ABHISHEK MANJUNATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 E WEST RD, CALUMET CITY, IL 60409-5415
(248) 875-9750
Mailing address
1215 LETICA DR, ROCHESTER, MI 48307-6085
(248) 875-9750
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036.168749
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2020
Last updated
01/13/2026
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