| Mannan Md Medical Clinic Llc | |
|
5230 Ky Route 321 Suite 6 Prestonsburg KY 41653-9168 | |
| (606) 889-9994 | |
| (606) 889-0909 |
| Full Name | Mannan Md Medical Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5230 Ky Route 321, Prestonsburg, Kentucky |
| Authorized Official Name and Position | Shoyeb Sikder (MANAGER) |
| Authorized Official Contact | 6068868880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mannan Md Medical Clinic Llc 5230 Ky Route 321 Suite 6 Prestonsburg KY 41653-9168 Ph: (606) 889-9994 | Mannan Md Medical Clinic Llc 5230 Ky Route 321 Suite 6 Prestonsburg KY 41653-9168 Ph: (606) 889-9994 |
| NPI Number | 1770976631 |
|---|---|
| Provider Enumeration Date | 03/16/2015 |
| Last Update Date | 03/16/2015 |
| Medicare PECOS PAC ID | 9133446453 |
|---|---|
| Medicare Enrollment ID | O20150326000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770976631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mohammad Mannan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588741904 PECOS PAC ID: 7618944745 Enrollment ID: I20141201002098 |
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