Provider Demographics
NPI:1205895265
Name:MANOLACHE, MIHAELA R (MD)
Entity type:Individual
Prefix:DR
First Name:MIHAELA
Middle Name:R
Last Name:MANOLACHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 391414
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-8414
Mailing Address - Country:US
Mailing Address - Phone:440-542-0392
Mailing Address - Fax:440-834-1902
Practice Address - Street 1:4200 WARRENSVILLE CENTER RD
Practice Address - Street 2:BUILDING A, SUITE 210
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7051
Practice Address - Country:US
Practice Address - Phone:216-491-7660
Practice Address - Fax:216-834-1902
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086379207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2685554Medicaid
OH4185151Medicare PIN
OH2685554Medicaid