Provider Demographics
NPI:1457332520
Name:MANUEL, MICHAEL DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DEAN
Last Name:MANUEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:301 4TH ST
Mailing Address - Street 2:MEDICAL TERRACE
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8423
Mailing Address - Country:US
Mailing Address - Phone:318-473-4632
Mailing Address - Fax:318-473-4633
Practice Address - Street 1:301 4TH ST
Practice Address - Street 2:MEDICAL TERRACE
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8423
Practice Address - Country:US
Practice Address - Phone:318-473-4632
Practice Address - Fax:318-473-4633
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA13249208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics