MEDICARE: HOWARD IRWIN MANELA DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	HM005424	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	950F329160	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1134289523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD IRWIN MANELA DC

Provider Business Mailing Address
First Line	:	1010 N CAMPBELL
Second Line	:	STE 6
City	:	ROYAL OAK
State	:	MI
Zip	:	48067
Country	:	US
Telephone Number	:	248-544-2400
Fax Number	:	248-544-3079

Provider Business Practice Location Address
First Line	:	28817 WOODWARD AVE
Second Line	:
City	:	BERKLEY
State	:	MI
Zip	:	48072-0915
Country	:	US
Telephone Number	:	248-544-2400
Fax Number	:	248-544-3079

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	07/03/2019

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