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General NPI Number Information
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NPI Number | 1114142650
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Entity Type | Organization
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Legal Business Name | STANLEY C. MANNINO, M.D., INC.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 485 COLLIERS WAY SUITE K
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City | WEIRTON
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State | WV
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Zip | 26062-5012
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Country | US
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Telephone | 304-723-3360
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Fax | 304-723-0569
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Provider Business Mailing Address
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Address Line | 485 COLLIERS WAY SUITE K
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City | WEIRTON
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State | WV
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Zip | 26062-5012
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Country | US
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Telephone | 304-723-3360
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Fax | 304-723-0569
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Authorized Official
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Title or Position | M.D.
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Name | DR. STANLEY C MANNINO
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Credential | M.D.
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Telephone | 304-723-3360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 13828
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License Number State | WV
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