Healthcare Provider Details

I. General information

NPI: 1083033401
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL MANIERI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21635 BIDEN AVE
GEORGETOWN DE
19947-4574
US

IV. Provider business mailing address

21635 BIDEN AVE UNIT 205
GEORGETOWN DE
19947-4576
US

V. Phone/Fax

Practice location:
  • Phone: 302-260-7360
  • Fax:
Mailing address:
  • Phone: 302-260-7360
  • Fax: 302-854-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0102206174
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: