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General NPI Number Information
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NPI Number | 1205924198
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Entity Type | Individual
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Provider Name | DEANNA ROCHELLE MANSKER M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 96 JONATHAN LUCAS ST MUSC DEPARTMENT OF SURGERY
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City | CHARLESTON
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State | SC
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Zip | 29425-8900
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Country | US
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Telephone | 843-792-3072
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Fax | 843-792-8286
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Provider Business Mailing Address
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Address Line | 17 SOLOMON CT
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City | CHARLESTON
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State | SC
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Zip | 29414-6825
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Country | US
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Telephone | 843-830-3486
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | LL28917
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License Number State | SC
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