Conrad C Manayan, DO
Surgery in Kennesaw, GA. Individual provider (NPI-1).
NPI number1902811656
StatusActive
Last updated in NPPESFeb 15, 2025
Details
- NPI
- 1902811656
- Entity type
- Individual (NPI-1)
- Name
- Conrad C Manayan
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 30, 2006
- Certification date
- Feb 15, 2025
- Last updated
- Feb 15, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | 98137 | GA | Yes |
| 202K00000X | Phlebology | 98137 | GA | |
| 208600000X | Surgery | 1300 | TN | |
| 208600000X | Surgery | 0480 | AL |
Practice location
3525 George Busbee Pkwy Nw Ste 101Kennesaw, GA 30144
Phone 800-991-6117
Mailing address
3820 Northdale Blvd Ste 201Tampa, FL 33624-1893
Phone 800-991-6117
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