Active NPI
Manuel I. Marban II, M.D.
- Specialist
- Saint Louis, MO
National Provider Identifier
1225251028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 33139
- Practice address
- 5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265 - Phone
- (314) 367-5820
- Fax
- (314) 367-6326
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 33139 | MO | Primary |
Addresses
Primary practice location
5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Mailing address
5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone (314) 367-5820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33139 | MO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1225251028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5471 DR MARTIN LUTHER KING DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631124265",
"telephone_number": "314-367-5820",
"fax_number": "314-367-6326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5471 DR MARTIN LUTHER KING DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631124265",
"telephone_number": "314-367-5820",
"fax_number": "314-367-6326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARBAN",
"first_name": "MANUEL",
"middle_name": "I.",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MO",
"license": "33139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.