Provider Demographics
NPI:1821387358
Name:MANCHESTER MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:MANCHESTER MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:FALGUNI
Authorized Official - Middle Name:KETAN
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-374-9500
Mailing Address - Street 1:3000 MANCHESTER RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-1850
Mailing Address - Country:US
Mailing Address - Phone:410-374-9500
Mailing Address - Fax:410-374-5311
Practice Address - Street 1:3000 MANCHESTER RD
Practice Address - Street 2:SUITE 5
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102-1850
Practice Address - Country:US
Practice Address - Phone:410-374-9500
Practice Address - Fax:410-374-5311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty