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General NPI Number Information
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NPI Number | 1184409617
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Entity Type | Organization
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Legal Business Name | ERIC J MANCINI MD, PC
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Dates
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Enumeration Date | 08/31/2023
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 2230 E MITCHELL RD
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City | PETOSKEY
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State | MI
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Zip | 49770-6601
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Country | US
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Telephone | 231-487-6688
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Fax | 231-865-3436
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Provider Business Mailing Address
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Address Line | 2230 E MITCHELL RD
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City | PETOSKEY
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State | MI
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Zip | 49770-6601
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Country | US
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Telephone | 231-487-6688
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Fax | 231-865-3436
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Authorized Official
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Title or Position | OWNER
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Name | ERIC J MANCINI
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Credential | MD
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Telephone | 231-487-6688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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