Provider Demographics
NPI:1568967388
Name:MANN, MANVEEN KAUR (MD)
Entity Type:Individual
Prefix:
First Name:MANVEEN
Middle Name:KAUR
Last Name:MANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 FISHCREEK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4316
Mailing Address - Country:US
Mailing Address - Phone:234-867-6960
Mailing Address - Fax:
Practice Address - Street 1:3825 FISHCREEK RD STE 200
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4316
Practice Address - Country:US
Practice Address - Phone:234-867-6960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-25
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35144366207R00000X
PAMD473188207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine