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General NPI Number Information
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NPI Number | 1528043643
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Entity Type | Individual
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Provider Name | ERIC M. MANIAGO MD
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Gender | Male
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 255 COMET DR
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City | CENTREVILLE
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State | MD
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Zip | 21617-2647
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Country | US
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Telephone | 443-262-4100
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Fax | 410-758-2185
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Provider Business Mailing Address
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Address Line | 160 COURSEVALL DR
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City | CENTREVILLE
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State | MD
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Zip | 21617-1824
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Country | US
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Telephone | 434-262-4100
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Fax | 410-758-2185
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | D0070683
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License Number State | MD
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