Provider Demographics
NPI:1649242009
Name:MANN, MICHAEL P (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:MANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 TOWN CENTER DR
Mailing Address - Street 2:SUITE 148
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1753
Mailing Address - Country:US
Mailing Address - Phone:215-752-2424
Mailing Address - Fax:215-750-0656
Practice Address - Street 1:825 TOWN CENTER DR
Practice Address - Street 2:SUITE 148
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1753
Practice Address - Country:US
Practice Address - Phone:215-752-2424
Practice Address - Fax:215-750-0656
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003696L207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0877387Medicaid
PAD77455Medicare UPIN
PA51841MYSMedicare ID - Type Unspecified