MEDICARE: RICHARD LEON MANRIQUE 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	207P00000X	Emergency Medicine Physician	031286	GA
2	208D00000X	General Practice Physician	031286	GA

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	:	1548299332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD LEON MANRIQUE MD

Provider Business Mailing Address
First Line	:	PO BOX 28118
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30358-0118
Country	:	US
Telephone Number	:	404-822-5605
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 EAGLE DR
Second Line	:	SUITE 200-B
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-8272
Country	:	US
Telephone Number	:	404-822-5605
Fax Number	:

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

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	09/21/2009

Similar Medicare Providers

1215880802 — ALAINA HOUSE LPTA
Practice Location Address:

1816 EAGLE DR STE 100
WOODSTOCK, GA
30189-8272

Practice Phone: 770-516-9191
Practice Fax:

1538210695 — DR. SCOTT HARDEN D.D.S.
Practice Location Address:

1816 EAGLE DR , BLDG 200 STE A
WOODSTOCK, GA
30189-8272

Practice Phone: 770-926-0000
Practice Fax: 770-924-0400

1972659332 — PT SOLUTIONS OF ACWORTH, LLC
Practice Location Address:

1816 EAGLE DR , BUILDING 100, SUITE C
WOODSTOCK, GA
30189-8272

Practice Phone: 770-516-9191
Practice Fax: 678-802-7377

1710022942 — DR. JULIUS PARK D.M.D.
Practice Location Address:

1816 EAGLE DR , 200-C
WOODSTOCK, GA
30189-8272

Practice Phone: 770-926-9260
Practice Fax: 770-926-9263

1750514295 — EAGLE DRIVE FAMILY MEDICINE PC
Practice Location Address:

1816 EAGLE DR , SUITE 200-B
WOODSTOCK, GA
30189-8272

Practice Phone: 678-445-5995
Practice Fax:

1346540432 — PARK PEDIATRIC DENTISTRY OF WOODSTOCK, LLC
Practice Location Address:

1816 EAGLE DR , SUITE 200-C
WOODSTOCK, GA
30189-8272

Practice Phone: 770-926-9260
Practice Fax: 770-926-9263

Directions to “ RICHARD LEON MANRIQUE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.