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General NPI Number Information
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NPI Number | 1609138387
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Entity Type | Organization
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Legal Business Name | MANHATTAN MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 200 RESEARCH DR
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City | MANHATTAN
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State | KS
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Zip | 66503-3049
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Country | US
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Telephone | 785-539-4644
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Fax | 785-539-8010
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Provider Business Mailing Address
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Address Line | 200 RESEARCH DR
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City | MANHATTAN
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State | KS
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Zip | 66503-3049
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Country | US
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Telephone | 785-539-4644
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Fax | 785-539-8010
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MARGARET MATSON
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Credential |
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Telephone | 785-539-4644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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