Provider Demographics
NPI:1073605952
Name:MANION, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:MANION
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3435 WEST BROADWAY
Mailing Address - Street 2:SUITE 1065
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422
Mailing Address - Country:US
Mailing Address - Phone:763-520-1137
Mailing Address - Fax:763-520-1976
Practice Address - Street 1:3435 WEST BROADWAY
Practice Address - Street 2:SUITE 1065
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:763-520-1137
Practice Address - Fax:763-520-1976
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN17358207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN373005OtherPREFERRED ONE
MN0413229OtherMEDICA
MN0413229OtherSELECT CARE
MN101041OtherUCARE
MN4T905MAOtherBLUE CROSS BLUE SHIELD
MNA94694OtherHEALTH PARTNERS
MN4T905MAOtherBLUE CROSS BLUE SHIELD