Doctor Name: | TEODORO A MANUBAY |
NPI Number: | 1700880788 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | R3317 |
Business Practice Address: | 1312 1st St Kennett, MO - 638572526 |
Business Phone Number: | 5738889823 |
Business Fax Number: | 5738883046 |
Mailing Address: | 1312 1st St, KENNETT |
State: | MO |
Postal Code: | 638572526 |
Phone Number: | 5738889823 |
Fax Number: | 5738883046 |
NPI Enumeration Date: | 06/08/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | R3317 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |