MEDICARE: SANJEEV V MANIAR MD PC

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	2084N0400X	Neurology Physician	50004554A	IN

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	:	1306065487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANJEEV V MANIAR MD PC

Provider Business Mailing Address
First Line	:	9250 COLUMBIA AVE
Second Line	:	SUITE C1
City	:	MUNSTER
State	:	IN
Zip	:	46321-3538
Country	:	US
Telephone Number	:	219-836-0039
Fax Number	:	219-836-0288

Provider Business Practice Location Address
First Line	:	9250 COLUMBIA AVE
Second Line	:	SUITE C1
City	:	MUNSTER
State	:	IN
Zip	:	46321-3538
Country	:	US
Telephone Number	:	219-836-0039
Fax Number	:	219-836-0288

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SANJEEV V MANIAR
Credential	:	MD
Telephone Number	:	219-836-0039

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	11/17/2009

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