Provider Demographics
NPI:1841521523
Name:BAYANI L. MANALO, M.D., LTD.
Entity type:Organization
Organization Name:BAYANI L. MANALO, M.D., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BAYANI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MANALO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-241-2400
Mailing Address - Street 1:6400 SEVEN CORNERS PL
Mailing Address - Street 2:SUITE G
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2009
Mailing Address - Country:US
Mailing Address - Phone:703-241-2400
Mailing Address - Fax:703-534-8506
Practice Address - Street 1:6400 SEVEN CORNERS PL
Practice Address - Street 2:SUITE G
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2009
Practice Address - Country:US
Practice Address - Phone:703-241-2400
Practice Address - Fax:703-534-8506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101022323207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6045961Medicaid
VAO30325Medicare UPIN
VA6045961Medicaid
VAC62136Medicare PIN