NPI: 1194494484 · DEARBORN, MI 48126 · Surgery Physician · NPI assigned 09/09/2021
| Authorized Official | MANIS, AUTUMN (ADMIN) |
| NPI Enumeration Date | 09/09/2021 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 13 | $11K |
| 2024 | 12 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 93458 | 25 | 25 | $20K |