Provider Demographics
NPI:1306071816
Name:RAWAT, MANISH (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:MANISH
Middle Name:
Last Name:RAWAT
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HHC 173RD STB
Mailing Address - Street 2:CMR 459 BOX 17405
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09139
Mailing Address - Country:US
Mailing Address - Phone:0162-273-0954
Mailing Address - Fax:
Practice Address - Street 1:173RD STB
Practice Address - Street 2:
Practice Address - City:BAMBERG
Practice Address - State:BAVARIA
Practice Address - Zip Code:09139
Practice Address - Country:DE
Practice Address - Phone:0162-273-0954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical