Provider Demographics
NPI:1689856387
Name:FRANCO, MANUEL T (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:T
Last Name:FRANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MANUEL
Other - Middle Name:T
Other - Last Name:FRANCO-MOLINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-1559
Mailing Address - Country:US
Mailing Address - Phone:304-487-1076
Mailing Address - Fax:304-425-9499
Practice Address - Street 1:608 NEW HOPE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2273
Practice Address - Country:US
Practice Address - Phone:304-487-1076
Practice Address - Fax:304-425-9499
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV230912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D08526Medicare UPIN