Provider Demographics
NPI:1740492230
Name:MANZER, MELISSA NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:NICOLE
Last Name:MANZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:NICOLE
Other - Last Name:BISCHOFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1102 N. 49TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132
Mailing Address - Country:US
Mailing Address - Phone:314-302-7435
Mailing Address - Fax:
Practice Address - Street 1:981045 NEBRASKA MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-1045
Practice Address - Country:US
Practice Address - Phone:402-559-1010
Practice Address - Fax:402-559-1011
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NE241872085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program