Healthcare Provider Details

I. General information

NPI: 1255278800
Provider Name (Legal Business Name): MANZER ALI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19550 EAST 39TH ST. SOUTH STE 310 INDEPENDENCE MO 64057
INDEPENDENCE MO
64057
US

IV. Provider business mailing address

MANZER ALI, H#291, ST 10, CHAK #2 JANUBI, TEHSIL AND DI
MANDI BAHAUDDIN PUNJAB
50400
PK

V. Phone/Fax

Practice location:
  • Phone: 805-697-2182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: