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NPI Code Detail

MEDICARE: MANOJ GHIMIRE MD

MEDICARE: MANOJ GHIMIRE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1104514975
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANOJ GHIMIRE MD
Provider Business Mailing Address
First Line : 608 S OAKLEY BLVD
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3509
Country : US
Telephone Number : 951-517-9720
Fax Number :
Provider Business Practice Location Address
First Line : 4422 3RD AVE
Second Line :
City : BRONX
State : NY
Zip : 10457-2545
Country : US
Telephone Number : 951-517-9720
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2023
Last Update Date : 02/17/2026

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