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Individual

OPHELIA V MANQUBAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2739 MIAMI VILLAGE DRIVE, MIAMISBURG, OH 45342
(937) 266-8267
(937) 436-3717
Mailing address
PO BOX 750370, DAYTON, OH 45475-0370
(937) 266-8267
(937) 436-3717

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35100223
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0272726
OH
Enumeration date
12/11/2007
Last updated
12/11/2007
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