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NPI Code Detail

MEDICARE: MATTHEW A MANNING MD

MEDICARE: MATTHEW A MANNING MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology Physician200100410NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2920006700OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316999857
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW A MANNING MD
Provider Business Mailing Address
First Line : 200 QUEENS RD STE 400
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-3264
Country : US
Telephone Number : 980-890-6063
Fax Number :
Provider Business Practice Location Address
First Line : 2400 W FRIENDLY AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1109
Country : US
Telephone Number : 336-832-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 05/31/2024

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