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NPI Code Detail

MEDICARE: DR. STEPHEN BERNARD MANALE M.D.

MEDICARE: DR. STEPHEN BERNARD MANALE 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
1208600000XSurgery Physician200129LA

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 : 1861497026
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN BERNARD MANALE M.D.
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 225-526-0011
Fax Number : 225-765-9196
Provider Business Practice Location Address
First Line : 1014 WEST ST. CLARE BLVD
Second Line : SUITE 3015
City : GONZALES
State : LA
Zip : 70737-2141
Country : US
Telephone Number : 225-743-2455
Fax Number : 225-743-2460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 01/22/2021

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