Individual
DR. NANCY M MANNISTO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
26657 WOODWARD AVE, STE 200, HUNTINGTON WOODS, MI 48070
(248) 398-8400
(248) 398-8487
Mailing address
26657 WOODWARD AVE, STE 200, HUNTINGTON WOODS, MI 48070
(248) 398-8400
(248) 398-8487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301061963
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3254614
—
MI
Enumeration date
12/22/2005
Last updated
07/08/2007
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