Provider Demographics
NPI:1659378982
Name:CAGA-ANAN, MANUEL LAGRIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:LAGRIA
Last Name:CAGA-ANAN
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 1:411 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:KS
Mailing Address - Zip Code:67950
Mailing Address - Country:US
Mailing Address - Phone:620-697-2175
Mailing Address - Fax:620-697-2185
Practice Address - Street 1:411 SUNSET DR
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:KS
Practice Address - Zip Code:67950
Practice Address - Country:US
Practice Address - Phone:620-697-2175
Practice Address - Fax:620-697-2185
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-26359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100270900AMedicaid
KS049304Medicare ID - Type Unspecified
KSG37719Medicare UPIN