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General NPI Number Information
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NPI Number | 1023217908
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Entity Type | Individual
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Provider Name | GINGER LYNNE MANOS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 3 RICHLAND MEDICAL PARK DR STE 330
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City | COLUMBIA
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State | SC
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Zip | 29203-6862
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Country | US
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Telephone | 803-434-7100
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Fax | 803-434-6889
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Provider Business Mailing Address
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Address Line | 600 CANALSIDE ST UNIT 4024
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City | COLUMBIA
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State | SC
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Zip | 29201-6050
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Country | US
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Telephone | 850-398-2548
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME112123
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 32487
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD32127
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD32487
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License Number State | SC
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