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General NPI Number Information
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NPI Number | 1083701858
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Entity Type | Individual
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Provider Name | GERALD EDWARD MANNING II P.A.C.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5050 DUNBAR SUITE D
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City | WASILLA
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State | AL
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Zip | 99654
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Country | US
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Telephone | 907-357-0820
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Fax | 907-357-0821
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Provider Business Mailing Address
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Address Line | PO BOX 876009
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City | WASILLA
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State | AK
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Zip | 99687
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Country | US
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Telephone | 907-357-0820
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Fax | 907-357-0821
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0059
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License Number State | AK
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