=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255278800
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MANZER ALI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2026
-----------------------------------------------------
Last Update Date | 05/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19550 EAST 39TH ST. SOUTH STE 310 INDEPENDENCE MO 64057
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-697-2182
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | MANZER ALI, H#291, ST 10, CHAK #2 JANUBI, TEHSIL AND DI
-----------------------------------------------------
City | MANDI BAHAUDDIN
-----------------------------------------------------
State | PUNJAB
-----------------------------------------------------
Zip | 50400
-----------------------------------------------------
Country | PK
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------