MEDICARE: JOHN MANUBAY MD LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1598001240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN MANUBAY MD LLC

Provider Business Mailing Address
First Line	:	4400 PENN AVE
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-8621
Country	:	US
Telephone Number	:	610-670-2522
Fax Number	:	610-670-7736

Provider Business Practice Location Address
First Line	:	4400 PENN AVE
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-8621
Country	:	US
Telephone Number	:	610-670-2522
Fax Number	:	610-670-7736

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN M MANUBAY
Credential	:	MD
Telephone Number	:	610-670-2522

Provider Enumeration Date	:	12/28/2012
Last Update Date	:	09/27/2023

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