MEDICARE: ASHAN MANOHAR 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	207RG0100X	Gastroenterology Physician	037701	CT
2	207RG0100X	Gastroenterology Physician	0101058609	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	037701	OTHER	CT	CONNECTICARE
2	0V6836	OTHER	CT	HEALTHNET NE
3	010037701CT01	OTHER	CT	ANTHEM BCBS CT
4	2543604	OTHER	CT	AETNA HMO
5	7122039	OTHER	CT	AETNA PPO
6	P1992625	OTHER	CT	OXFORD

General Provider Information

NPI Number	:	1295725836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHAN MANOHAR M.D.

Provider Business Mailing Address
First Line	:	856 J CLYDE MORRIS BLVD STE A
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23601-1318
Country	:	US
Telephone Number	:	757-316-5800
Fax Number	:	757-534-5190

Provider Business Practice Location Address
First Line	:	20486 MARKET STREET
Second Line	:
City	:	ONANCOCK
State	:	VA
Zip	:	23417
Country	:	US
Telephone Number	:	757-302-2700
Fax Number	:	757-787-9262

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	03/23/2020

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Directions to “ ASHAN MANOHAR M.D.” Practice Location

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