Provider Demographics
NPI:1790893451
Name:MICHAEL A MCMANN M.D., LLC
Entity Type:Organization
Organization Name:MICHAEL A MCMANN M.D., LLC
Other - Org Name:MCMANN EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER & OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:MCMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-489-3154
Mailing Address - Street 1:91-2139 FORT WEAVER RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3607
Mailing Address - Country:US
Mailing Address - Phone:808-677-2733
Mailing Address - Fax:808-441-7737
Practice Address - Street 1:91-2139 FORT WEAVER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3608
Practice Address - Country:US
Practice Address - Phone:808-677-2733
Practice Address - Fax:808-441-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10374207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HII27995Medicare UPIN
HI6025500001Medicare NSC
HIH101867Medicare PIN