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General NPI Number Information
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NPI Number | 1104897537
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Entity Type | Individual
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Provider Name | STEWART CLEAVES MANNING M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1121 N ROAD ST STE A
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3470
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Country | US
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Telephone | 252-338-2144
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Fax | 252-338-2145
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Provider Business Mailing Address
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Address Line | 1121 N ROAD ST STE A
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-3353
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Country | US
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Telephone | 252-338-2144
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Fax | 252-338-2145
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 38380
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 38380
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 38380
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License Number State | NC
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