Manoher Bearelly, M.D.
Individual provider Active NPI Child & Adolescent Psychiatry Physician · Hannibal, MO
NPI 1407925241 · NPPES record last updated Feb 29, 2016
Key facts
- NPI
- 1407925241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatry Physician 2084P0804X
- License
- 2011033071 (MO)
- Practice address
- 141 Communication Dr
Hannibal, MO 63401-3670 - Phone
- (573) 603-1460
- Fax
- (573) 603-1462
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036058614 | IL | MD | Child & Adolescent Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 036058614 | IL | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 2011033071 | MO | Yes |
Addresses
Primary practice location
141 Communication Dr
Hannibal, MO 63401-3670
Mailing address
900 E Laharpe St
Kirksville, MO 63501-4520
Phone (660) 665-1962
Other providers in Hannibal, MO
- Rahul Basho
- Joseph Edward Bass
- Deborah A Baumann
- Richard Leo Baumann Jr.
- Joseph M Bean
- Claire Becker-Horneker
- Felicia M Begley
- Branislav D Behan
- Hassan Behniay
- Hossein Behniaye
All providers in Hannibal, MO · Child & Adolescent Psychiatry Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 29, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.