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NPI Code Detail

MEDICARE: PETRICA MANOLACHE MD

MEDICARE: PETRICA 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
1207R00000XInternal Medicine Physician35076221MOH

Other Identifiers

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

General Provider Information

NPI Number : 1447219415
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETRICA MANOLACHE MD
Provider Business Mailing Address
First Line : PO BOX 391414
Second Line :
City : SOLON
State : OH
Zip : 44139-8414
Country : US
Telephone Number : 216-491-7660
Fax Number : 440-834-1902
Provider Business Practice Location Address
First Line : 4180 WARRENSVILLE CENTER RD
Second Line : BUILDING A, SUITE 120
City : BEACHWOOD
State : OH
Zip : 44122-7024
Country : US
Telephone Number : 216-491-7660
Fax Number : 440-834-1902
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 12/20/2007

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