Provider Demographics
NPI:1508061698
Name:MANOV, NAGIB (MD)
Entity Type:Individual
Prefix:
First Name:NAGIB
Middle Name:
Last Name:MANOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DELAFIELD RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3247
Mailing Address - Country:US
Mailing Address - Phone:412-784-5050
Mailing Address - Fax:412-784-5077
Practice Address - Street 1:100 DELAFIELD RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3247
Practice Address - Country:US
Practice Address - Phone:412-784-5050
Practice Address - Fax:412-784-5077
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429522207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine