Provider Demographics
NPI:1992764039
Name:MANES, MICHAEL R (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:MANES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:810 SAINT VINCENTS DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1601
Mailing Address - Country:US
Mailing Address - Phone:205-558-3484
Mailing Address - Fax:317-583-3099
Practice Address - Street 1:6945 COUNTY HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:AL
Practice Address - Zip Code:35049-3927
Practice Address - Country:US
Practice Address - Phone:205-625-3367
Practice Address - Fax:205-274-0857
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2019-07-12
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Provider Licenses
StateLicense IDTaxonomies
AL11937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC72545Medicare UPIN