Healthcare Provider Details

I. General information

NPI: 1134112519
Provider Name (Legal Business Name): ANNE MARIE MANNING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 04/04/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 WALNUT BOTTOM RD
SHIPPENSBURG PA
17257-8131
US

IV. Provider business mailing address

127 WALNUT BOTTOM RD
SHIPPENSBURG PA
17257-8131
US

V. Phone/Fax

Practice location:
  • Phone: 717-218-1820
  • Fax: 717-706-6735
Mailing address:
  • Phone: 717-218-1820
  • Fax: 717-706-6735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD043833E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: