Manyam, Bose

Manyam, Bose is an individual health care provider with primary practice located at 201 E Oak Ave , Jonesboro AR 72401-4163. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Manyam, Bose can be contacted via phone (870) 268-4404.

Contact Information

Primary practice address
201 E Oak Ave Jonesboro AR 72401-4163
Fax: (870) 268-4478
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X E-11902 Arkansas

Profile Details

NPI number 1811952237
LBN Legal business name Manyam, Bose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Mar 16th, 2020 - about 4 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 1811952237 NPPES
Arkansas MEDICAID 231587001

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