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NPI Code Detail

MEDICARE: PHILLIP JOSEPH MANNO MD

MEDICARE: PHILLIP JOSEPH MANNO MD
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
1207RH0003XHematology & Oncology Physician6440NV
2207RH0003XHematology & Oncology Physician15718NH
3207RH0000XHematology (Internal Medicine) PhysicianME158787FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649271438
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP JOSEPH MANNO MD
Provider Business Mailing Address
First Line : C/O ST MARY'S HEALTH SYSTEM - PROVIDER ENROLLMENT
Second Line : PO BOX 7291
City : LEWISTON
State : ME
Zip : 04243-7291
Country : US
Telephone Number : 207-777-8695
Fax Number : 208-777-8800
Provider Business Practice Location Address
First Line : 2501 N ORANGE AVE STE 689
Second Line :
City : ORLANDO
State : FL
Zip : 32804-4648
Country : US
Telephone Number : 407-303-2024
Fax Number : 407-303-2038
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 03/01/2023

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Directions to “ PHILLIP JOSEPH MANNO MD” Practice Location

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