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General NPI Number Information
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NPI Number | 1043217086
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Entity Type | Individual
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Provider Name | STUART HALL MANNING M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2005
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 508 FULTON ST C/O DURHAM VA MEDICAL CENTER
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City | DURHAM
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State | NC
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Zip | 27705-3875
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Country | US
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Telephone | 919-599-7036
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Fax | 919-226-0390
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Provider Business Mailing Address
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Address Line | 177 MONTROSE DR
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City | DURHAM
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State | NC
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Zip | 27707-3929
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Country | US
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Telephone | 919-599-7036
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Fax | 919-226-0390
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0023213
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License Number State | NC
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