David L Manzo MD PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DAVID L MANZO MD PC

Practice address

621 W 11 Mile Rd
Royal Oak, MI 48067-2201

Phone

(248) 541-4200

Fax

(248) 541-4969

NPI assigned

May 8, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David L Manzo, M.D.

Title

Owner

Phone

(248) 541-4200

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1972779072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 W 11 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672201",
            "telephone_number": "248-541-4200",
            "fax_number": "248-541-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W 11 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672201",
            "telephone_number": "248-541-4200",
            "fax_number": "248-541-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L MANZO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "MANZO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-541-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4113369",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4229975 TYPE 10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF MI",
            "identifier": "1806373281",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chip Davenport
• Julie Davenport, CRC, LPC
• Melanie Joy Davenport, LMSW, CLINICAL
• David a Decker MD
• David E. Beneson D.P.M., P.C.
• David L. Manzo, M.D., P.C.
• David Sinawi, PLLC
• David Vandam LLC
• Eric Matthew David, LLMSW
• Andrew Edward Davidek, DO

• Clinic/Center in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.