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General NPI Number Information
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NPI Number | 1811155112
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Entity Type | Individual
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Provider Name | NATHAN ANDREW MANN DO
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Gender | Male
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 825 N CENTER AVE
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City | GAYLORD
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State | MI
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Zip | 49735-1592
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Country | US
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Telephone | 989-731-7996
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Fax | 989-731-9151
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Provider Business Mailing Address
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Address Line | 1105 SIXTH ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2386
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101018681
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License Number State | MI
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