Provider Demographics
NPI:1871749168
Name:MANKOWSKI, MICHAL W (PT)
Entity type:Individual
Prefix:
First Name:MICHAL
Middle Name:W
Last Name:MANKOWSKI
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:2909 CHESTNUT HILL DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3411
Mailing Address - Country:US
Mailing Address - Phone:410-750-9392
Mailing Address - Fax:410-750-8931
Practice Address - Street 1:405 FREDERICK RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4645
Practice Address - Country:US
Practice Address - Phone:410-744-8698
Practice Address - Fax:410-744-8699
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD15445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD03186OtherAMERIGROUP
MD062318101Medicaid
MD22309OtherMAMSI
MD5800456OtherAETNA PPO
MD18692OtherKAISER PERMANENTE MID-ATLANTIC STATES
MD2143999OtherAETNA HMO
MD22309OtherOPTIMUM CHOICE
MDR7760001OtherCAREFIRST BLUECROSS/BLUE SHIELD FEDERAL EMPLOYEES PROGRAM
MDR776OtherCAREFIRST BLUE CHOICE
MD1027OtherBRAVO HEALTH
MD22309OtherM.D. IPA
MD22309OtherALLIANCE
MD521419637OtherMULTIPLAN PPO
MDJ512OtherCAREFIRST BLUE CROSS/BLUE SHIELD OF MARYLAND
MD146173400OtherO.W.C.P.
MD8010223PTOtherCIGNA PPO
MD22309OtherALLIANCE