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1023018074
KANNAN MANICKAM
BALTIMORE, MD
NPI
1023018074
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208800000X Urology
(Licence: IN 01056563A)
Enumeration Date
2005-07-29
Last Update Date
2014-04-23
Business Address
-- KANNAN MANICKAM MD
6820 HOSPITAL DR SUITE 210
BALTIMORE, MD 21237-4352
Phone number: 410-391-6131
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Mailing Address
-- KANNAN MANICKAM MD
25 CROSSROADS DR STE 306
OWINGS MILLS, MD 21117-5421
Phone number: 443-738-2889
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