MEDICARE: DR. MIHAELA R MANOLACHE 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
1	207R00000X	Internal Medicine Physician	35086379	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205895265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIHAELA R MANOLACHE MD

Provider Business Mailing Address
First Line	:	PO BOX 391414
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-8414
Country	:	US
Telephone Number	:	440-542-0392
Fax Number	:	440-834-1902

Provider Business Practice Location Address
First Line	:	4200 WARRENSVILLE CENTER RD
Second Line	:	BUILDING A, SUITE 210
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-7051
Country	:	US
Telephone Number	:	216-491-7660
Fax Number	:	216-834-1902

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	03/31/2008

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