Individual
DR. MOHANNAD MOHAMMAD MANNAA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV PED ALLERGY/IMMUNO/PULMO, SAINT LOUIS, MO 63110-1002
(314) 454-2694
(314) 454-2515
Mailing address
PO BOX 60352, SAINT LOUIS, MO 63160-0352
(314) 454-2694
(314) 454-2515
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2022010517
MO
2080P0214X
Pediatric Pulmonology Physician
036136514
IL
2080P0214X
Pediatric Pulmonology Physician
Primary
2022010517
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200108532
—
MO
Enumeration date
07/05/2006
Last updated
09/25/2024
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