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Individual

CONRAD C MANAYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3525 GEORGE BUSBEE PKWY NW STE 101, KENNESAW, GA 30144
(800) 991-6117
Mailing address
3820 NORTHDALE BLVD STE 201, TAMPA, FL 33624-1893
(800) 991-6117

Taxonomy

Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
98137
GA
208600000X
Surgery Physician
0480
AL
208600000X
Surgery Physician
1300
TN
208600000X
Surgery Physician
Primary
98137
GA

Other

Enumeration date
07/30/2006
Last updated
02/15/2025
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