=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013914159
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SEAN P MANION MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2005
-----------------------------------------------------
Last Update Date | 03/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1610 PRAIRIE CENTER PKWY STE 2233
-----------------------------------------------------
City | BRIGHTON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80601-4000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-227-0977
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10200 GRAND CENTRAL AVE STE 220
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117-4366
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | DR.0038593
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------