MEDICARE: CHERYL A MANNING MD

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	208000000X	Pediatrics Physician	048273	GA

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

General Provider Information

NPI Number	:	1881645174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL A MANNING MD

Provider Business Mailing Address
First Line	:	4106 MILL ST NE
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014-2539
Country	:	US
Telephone Number	:	770-786-0012
Fax Number	:	770-786-9988

Provider Business Practice Location Address
First Line	:	4106 MILL ST NE
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014-2539
Country	:	US
Telephone Number	:	770-786-0012
Fax Number	:	770-786-9988

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	05/09/2011

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