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General NPI Number Information
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NPI Number | 1235182106
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Entity Type | Individual
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Provider Name | MANOJ G MASSAND MD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 350 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85013-4496
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Country | US
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Telephone | 602-954-6228
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Fax | 602-957-6142
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Provider Business Mailing Address
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Address Line | PO BOX 44037
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City | PHOENIX
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State | AZ
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Zip | 85064-4037
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Country | US
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Telephone | 602-954-6228
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Fax | 602-957-6142
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | L1130
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25811
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 83877
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 49229
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 31215
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License Number State | AZ
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