MEDICARE: DR. MICHAEL ARTHUR MCMANN M.D.

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	207W00000X	Ophthalmology Physician	MD-10374	HI

General Provider Information

NPI Number	:	1215941190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ARTHUR MCMANN M.D.

Provider Business Mailing Address
First Line	:	91-2139 FORT WEAVER RD
Second Line	:	SUITE 202
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3607
Country	:	US
Telephone Number	:	808-677-2733
Fax Number	:	808-441-7737

Provider Business Practice Location Address
First Line	:	91-2139 FORT WEAVER RD
Second Line	:	SUITE 202
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3607
Country	:	US
Telephone Number	:	808-677-2733
Fax Number	:	808-441-7737

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	03/11/2008

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