Provider Demographics
NPI:1780090191
Name:MANEK, KAMRAN ABBAS (MD)
Entity type:Individual
Prefix:DR
First Name:KAMRAN
Middle Name:ABBAS
Last Name:MANEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 FARMSTEAD ROAD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:415
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14872 YONGE STEET
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:ON
Practice Address - Zip Code:L4G 1N2
Practice Address - Country:CA
Practice Address - Phone:905-841-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ113947207Q00000X
MI4301105713207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine