Provider Demographics
NPI:1417368770
Name:IZZY, MANHAL (MD)
Entity type:Individual
Prefix:DR
First Name:MANHAL
Middle Name:
Last Name:IZZY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MANHAL
Other - Middle Name:
Other - Last Name:OLAYWI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 THE VANDERBILT CLINIC
Practice Address - Street 2:30330
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204
Practice Address - Country:US
Practice Address - Phone:615-322-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN61780207R00000X, 207RG0100X, 207RT0003X
TN57561207RG0100X, 207RT0003X
TNMD57561207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology