Manjoros, Demitra T

Manjoros, Demitra T is an individual health care provider with primary practice located at 7700 E Florentine Rd Bldg B, Ste. 203, Prescott Valley AZ 86314-2245. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Manjoros, Demitra T can be contacted via phone (928) 442-8740.

Contact Information

Primary practice address
7700 E Florentine Rd Bldg B, Ste. 203 Prescott Valley AZ 86314-2245
Phone: (928) 442-8740
Fax: (928) 442-8142
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 36049 Arizona
Allopathic & Osteopathic Physicians / Surgery 208600000X DR.0052970 Colorado

Profile Details

NPI number 1811960651
LBN Legal business name Manjoros, Demitra T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2006
Last updated Feb 3rd, 2016 - about 8 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 1811960651 NPPES
Arizona MEDICAID 81522886
Arizona Other 36049

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