Basic Information
| Provider Information | |||||||||
| NPI: | 1366534042 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MANIAR | ||||||||
| FirstName: | KANAN | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 E JEFFERSON ST | ||||||||
| Address2: | KAISER PERMANENTE MEDICARE ENROLLMENT | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018162424 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 12011 LEE JACKSON MEMORIAL HWY | ||||||||
| Address2: | PENDERBROOK MEDICAL CENTER | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220333310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033835400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 12/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | D0064700 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 0101247156 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.