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Contact Information

MANUEL L SAN, DO
2101 CORONA RD STE 102
COLUMBIA, MO65203-2582
 Phone: 573-234-1800
 Fax: 573-234-1799
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MANUEL L SAN · (Male)

NPI # 1245443548
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/07/2007
Last updated 07/21/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2006029319
  • MO Medicaid 1245443548
  • MO Medicaid 207024605
  • MO Other P00770996 RR MEDICARE PTAN
Hospital affiliation(s)
  • HANNIBAL REGIONAL HOSPITAL - (Acute Care)
    6000 HOSPITAL DR
    HANNIBAL, MO 63401
  • PIKE COUNTY MEMORIAL HOSPITAL - (Critical Access)
    2305 WEST GEORGIA STREET
    LOUISIANA, MO 63353
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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