Healthcare Provider Details

I. General information

NPI: 1497233100
Provider Name (Legal Business Name): MICHAEL MCMANUS CNIM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 CORPORATE WAY SUITE 212 EVOKES LLC
CINCINNATI OH
45202
US

IV. Provider business mailing address

8118 CORPORATE WAY SUITE 212 EVOKES LLC
CINCINNATI OH
45202
US

V. Phone/Fax

Practice location:
  • Phone: 513-947-8433
  • Fax: 513-947-9943
Mailing address:
  • Phone: 513-947-8433
  • Fax: 513-947-9943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: