Provider Demographics
NPI:1568063006
Name:GHALEY, MAN BAHADUR
Entity Type:Individual
Prefix:
First Name:MAN
Middle Name:BAHADUR
Last Name:GHALEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3061 32ND ST S APT 1
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-7865
Mailing Address - Country:US
Mailing Address - Phone:701-561-8661
Mailing Address - Fax:
Practice Address - Street 1:3061 32ND ST S APT 1
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-7865
Practice Address - Country:US
Practice Address - Phone:701-561-8661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant