Individual
DR. BRUCE A. MANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1625 E NORTHERN AVE, SUITE 103, PHOENIX, AZ 85020-3960
(602) 200-9021
(602) 200-9087
Mailing address
2443 E MELROSE ST, MESA, AZ 85213-1564
(480) 615-1514
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28105
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
513748
—
AZ
Enumeration date
03/01/2006
Last updated
10/11/2011
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