Provider Demographics
NPI:1609357029
Name:MAGAR, MAN B I
Entity Type:Individual
Prefix:
First Name:MAN
Middle Name:B
Last Name:MAGAR
Suffix:I
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 1:9182 BLACK ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-1823
Mailing Address - Country:US
Mailing Address - Phone:585-752-6703
Mailing Address - Fax:
Practice Address - Street 1:9182 BLACK ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1823
Practice Address - Country:US
Practice Address - Phone:585-752-6703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator