Provider Demographics
NPI:1184479974
Name:MANIS, LUKE STUART
Entity type:Individual
Prefix:MR
First Name:LUKE
Middle Name:STUART
Last Name:MANIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4870 WUNNENBERG WAY
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4863
Mailing Address - Country:US
Mailing Address - Phone:513-860-4600
Mailing Address - Fax:
Practice Address - Street 1:4870 WUNNENBERG WAY
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4863
Practice Address - Country:US
Practice Address - Phone:513-860-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.009105RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical