1659482347 NPI number — ALBERT SM MANLAPIT M.D. PLLC

Table of content: (NPI 1659482347)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659482347 NPI number — ALBERT SM MANLAPIT M.D. PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBERT SM MANLAPIT M.D. PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659482347
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5453 HAMPTON PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48604-8213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-797-2663
Provider Business Mailing Address Fax Number:
989-797-4263

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5453 HAMPTON PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48604-9284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-797-2663
Provider Business Practice Location Address Fax Number:
989-797-4263
Provider Enumeration Date:
08/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MANLAPIT
Authorized Official First Name:
ALBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
989-797-2663

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  4301062315 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0M86690 . This is a "MEDICARE PTAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4120375 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1004552 . This is a "MCLAREN ADVANTAGE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1107301042 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 660002906 . This is a "TRAVELERS MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0982605 . This is a "HEALTH PLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1107301042 . This is a "BLUE CROSS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".