MEDICARE: DR. GINGER LYNNE MANOS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	ME112123	FL
2	2086S0129X	Vascular Surgery Physician	32487	SC
3	2086S0129X	Vascular Surgery Physician	MD32127	AL
4	2086S0129X	Vascular Surgery Physician	MD32487	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023217908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GINGER LYNNE MANOS M.D.

Provider Business Mailing Address
First Line	:	600 CANALSIDE ST UNIT 4024
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-6050
Country	:	US
Telephone Number	:	850-398-2548
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 RICHLAND MEDICAL PARK DR STE 330
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6862
Country	:	US
Telephone Number	:	803-434-7100
Fax Number	:	803-434-6889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	06/07/2024

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Directions to “ DR. GINGER LYNNE MANOS M.D.” Practice Location

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