Provider Demographics
NPI:1215941190
Name:MCMANN, MICHAEL ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARTHUR
Last Name:MCMANN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:91-2139 FORT WEAVER RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3607
Mailing Address - Country:US
Mailing Address - Phone:808-677-2733
Mailing Address - Fax:808-441-7737
Practice Address - Street 1:91-2139 FORT WEAVER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3607
Practice Address - Country:US
Practice Address - Phone:808-677-2733
Practice Address - Fax:808-441-7737
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD-10374207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH101868Medicare PIN
HII27995Medicare UPIN