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NPI Code Detail

MEDICARE: DR. MICHAEL NASR MANKARIOUS M.D.

MEDICARE: DR. MICHAEL NASR MANKARIOUS M.D.
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
1207R00000XInternal Medicine Physician28726IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110076724OTHERIARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
153222OTHERIABLUE CROSS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659375921
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL NASR MANKARIOUS M.D.
Provider Business Mailing Address
First Line : 621 S ILLINOIS AVE
Second Line : SUITE 103
City : MASON CITY
State : IA
Zip : 50401-5405
Country : US
Telephone Number : 641-428-3041
Fax Number : 641-428-3059
Provider Business Practice Location Address
First Line : 638 S BLUFF BLVD
Second Line :
City : CLINTON
State : IA
Zip : 52732-4742
Country : US
Telephone Number : 563-243-5601
Fax Number : 563-243-5637
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 03/29/2017

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