Mannisto, Nancy M

Mannisto, Nancy M is an individual health care provider with primary practice located at 26657 Woodward Ave Ste 200, Huntington Woods MI 48070. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mannisto, Nancy M can be contacted via phone (248) 398-8400.

Contact Information

Primary practice address
26657 Woodward Ave Ste 200 Huntington Woods MI 48070
Fax: (248) 398-8487
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301061963 Michigan

Profile Details

NPI number 1861478612
LBN Legal business name Mannisto, Nancy M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861478612 NPPES
Michigan MEDICAID 3254614

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