MEDICARE: DR. SARAH MANALANSAN MANNEH M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	45050	MN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1797934	OTHER	MN	AMERICA'S PPO
2	HP38103	OTHER	MN	HEALTHPARTNERS
3	7613467	OTHER	MN	AETNA INS
4	351J1MA	OTHER	MN	BCBS OF MN
5	1034191	OTHER	MN	PREFERRED ONE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	0703468	OTHER	MN	MEDICA #
8	171112	OTHER	MN	UCARE MN

NPI Number	:	1285663112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH MANALANSAN MANNEH M.D.

Provider Business Mailing Address
First Line	:	5700 BOTTINEAU BLVD
Second Line	:	#210
City	:	CRYSTAL
State	:	MN
Zip	:	55429-3183
Country	:	US
Telephone Number	:	763-587-7000
Fax Number	:	763-587-7015

Provider Business Practice Location Address
First Line	:	5700 BOTTINEAU BLVD
Second Line	:	#210
City	:	CRYSTAL
State	:	MN
Zip	:	55429-3183
Country	:	US
Telephone Number	:	763-587-7000
Fax Number	:	763-587-7015

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

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	06/30/2022

5700 BOTTINEAU BLVD , SUITE 200
CRYSTAL, MN
55429-3183

Practice Phone: 763-535-7607
Practice Fax: 763-535-7649

5700 BOTTINEAU BLVD , #210
CRYSTAL, MN
55429-3183